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Carotid artery restenosis: an ongoing disease process
Vijay Trisal1, Tammeral Paulson, Sachinder S Hans
1Department of Surgery, Providence Hospital and Medical Center, Southfield, Michigan 48075, USA.
The American Surgeon
|March 15, 2002
Summary
Surgical treatment for recurrent carotid artery stenosis is safe and effective. This study found that re-operation for recurring blockages in carotid arteries had no neurological complications and is a viable option.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Recurrence of carotid artery stenosis after endarterectomy is common.
- Optimal management strategies for recurrent disease remain debated.
- Risk factors include hypertension, peripheral vascular disease, and smoking.
Purpose of the Study:
- To evaluate the outcomes of surgical intervention for recurrent carotid artery stenosis.
- To assess the safety and efficacy of re-operation.
- To analyze outcomes in patients with contralateral carotid artery occlusion.
Main Methods:
- Retrospective review of carotid endarterectomies for recurrent disease over 21 years.
- Data collected on patient demographics, risk factors, and surgical outcomes.
- Analysis of complications, including neurological events and mortality.
Main Results:
- Eighty-two recurrences were identified in 1648 endarterectomies.
- Females had a slightly higher recurrence rate.
- No postoperative neurological events or permanent nerve damage occurred; one death from coronary artery disease.
- 14 endarterectomies in 11 patients with contralateral occlusion had no neurological complications.
Conclusions:
- Surgical treatment for recurrent carotid artery stenosis is a safe option.
- Continued surveillance for occlusive carotid disease is recommended.
- Carotid endarterectomy for recurrent disease with contralateral occlusion can be performed safely.