Carotid angioplasty and stenting: Treatment of postcarotid endarterectomy restenosis is at least as safe as primary stenosis treatment

Abstract

CAS for restenosis after CEA has a complication rate lower than primary CAS. The time interval between CEA and CAS did not influence micro embolic load.

Carotid angioplasty and stenting is safe and effective for treatment of recurrent stenosis after eversion endarterectomy

“…This could be because there were more asymptomatic patients (69% vs 31%) who were also significantly older (65.92 6 7.8 years vs 62.92 6 7.67 years; P ¼ .002). Similarly as in the studies published so far, 11,14,26 most of the patients in our study were asymptomatic (69%); still, the follow-up in the present study was significantly longer (range, 17-121 months). That no lethal outcomes were verified in symptomatic patients might seem surprising; however, the overall mortality rate was 3.13%, making the results of the present study appropriate and authentic.…”

Stenting Versus Endarterectomy for Restenosis Following Prior Ipsilateral Carotid Endarterectomy

“…From the 84 eligible articles (7609 patients, possibly including duplicate patients and interventions others than CEA/CAS), we received IPD from 13 studies. 15,16,18,19,[24][25][26][27][28][29][30][31][32] From the remaining 71 studies, IPD could not be retrieved because 30 authors did not respond, 26 did respond but the data were not available [no access to the data anymore without a clear reason why (13); no access to the data anymore because of change of institution, retirement, or institutional/study group restrictions (7); data destroyed or lost (4); data not digital (2)]. Three studies replied, but only provided summary data, and 11 study groups responded that they were not willing to participate (unknown reasons).…”

Open surgery remains a valid option for the treatment of recurrent carotid stenosis

“…Regarding the rate of immediate neurologic and/or fatal complications, our results seem to be similar to those reported in previous series (Table V) 12,13, but also to those published with CAS (Table VI). 10,11,[49][50][51][52][53][54][55][56][57] Indeed, apart from two series of OS with a CMSM of 10.5, and 9.7%, respectively, all reported rates of CMSM were between 0% and 6.3% regardless of the technique used (Tables V and VI).…”