57. Rezidivstenosen nach Carotis-TEA

Abstract

Follow-up of 798 patients by Duplex scanning or digital venous angiography 6 months to 13 years after carotid endarterectomy revealed a recurrent stenosis rate of 3.4%. The incidence of the recurrent lesions showed a clear correlation with the operative technique: after closure of the arteriotomy directly (continuous suture) or with a vein patch (303 pat.) the recurrent stenosis rate was 4 times higher than after closure with a dacron patch (495 pat.). Our investigations indicate that recurrent stenosis and occlusions after carotid endarterectomy are largely avoidable. Sufficient length of arteriotomy (5-8 cm), dilatation of the distal internal carotid artery and lumen congruent closure of the arteriotomy with a dacron patch are the pivots of success.