title: Elasticity of the carotid artery walls as a prognostic factor for the occurrence of restenosis after a surgery for internal carotid artery stenosis.
abstract: BACKGROUND
  Restoration of carotid artery patency is one of the most frequently performed operations in vascular surgery. One of the most important problems that occur both short- and long-term after carotid endarterectomy is recurrent stenosis. Despite advances in imaging studies and better knowledge of the mechanisms of atherogenesis, the mechanism of restenosis remains unclear. Patients with internal carotid artery atherosclerosis experience decreased elasticity of the intima-media complex, resulting in increased vessel wall stiffness. In the future, measurement of carotid artery elasticity may become a marker for the development of post-surgical stenosis occurring after endarterectomy of both the carotid artery and other peripheral vessels.
  
  
  OBJECTIVE
  To assess the elasticity of carotid artery walls as a prognostic factor for the occurrence of restenosis after a surgery for common carotid artery stenosis.
  
  
  METHODS
  Classic carotid artery endarterectomy was performed in 180 patients selected on the basis of standard, ultrasound- based recommendations. The phenomenon of restenosis was examined using ultrasound techniques at 3, 6, 9 and 12 months after the surgery. Measurements of carotid artery elasticity were performed using a Vascular Echo Doppler device, and patients were divided into two groups depending on the occurrence (or non-occurrence) of restenosis.
  
  
  RESULTS
  Group I (without restenosis) included 156 (86.6%) patients, and Group II (with restenosis) included 24 (13.4%) patients. At 3 and 6 months after the surgery, an increase of the elasticity of vessel walls (coefficient a) was observed in both groups, but the differences in the elasticity of the carotid arteries were not significant. At 12 months after the surgery, all patients in Group II (with restenosis) had significantly increased coefficient a values as compared to Group I patients (p < 0.05).
  
  
  CONCLUSIONS
  A decrease in carotid artery wall elasticity as measured using coefficient a may be associated with the process leading to the occurrence of restenosis after the surgery. Further research is required in order to confirm the conclusions presented in this paper and to explain potential mechanisms of this phenomenon.
authors.affiliation: Department of Vascular Surgery and Angiology, Centre for Postgraduate Medical Education, Warsaw, Poland. eberhardt@wp.pl.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Eberhardt
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Madycki
authors.forename: Włodzimierz
authors.initials: W
authors.lastname: Hendiger
authors.forename: Walerian
authors.initials: W
authors.lastname: Staszkiewicz
authors.forename: Adam
authors.initials: A
authors.lastname: Lewszuk
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000473:pathology; D002343:Carotid Artery, Internal / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000473:pathology / Q000601:surgery*; D004548:Elasticity; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D018616:Ultrasonography, Doppler, Duplex