Carotid endarterectomy with stent removal in management of in-stent restenosis: a safe, feasible, and effective technique.
BACKGROUND
The optimal treatment of in-stent restenosis (ISR) is not determined. We describe the efficacy of carotid endarterectomy (CEA) with stent removal in the management of symptomatic ISR.


METHODS
A 72-year-old man presented with recurrent right limb weakness 8 months after carotid artery stenting. Digital substraction angiography showed severe ISR (almost 99%). CEA with stent removal was performed.


RESULTS
A total of 41 cases was reviewed: periarterial inflammation was shown in 10.3% of patients; 92.9% had clear intima-media plane; and 85.4% had a good outcome. All patients remained stable at follow-up.


CONCLUSIONS
CEA with stent removal appears to be a safe, feasible, effective, and durable therapeutic option.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J
J
Zheng
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
L
L
Liu
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Y
Y
Cao
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
D
D
Zhang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: ronger090614@yahoo.cn.
R
R
Wang
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. Electronic address: zhaojz205@hotmail.com.
J
J
Zhao
D000368:Aged; D015901:Angiography, Digital Subtraction; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D020878:Device Removal; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D012008:Recurrence; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Carotid artery stenting (CAS); Carotid endarterectomy (CEA); In-stent restenosis (ISR); Stent removal