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Homocysteine as a risk factor of restenosis after carotid endarterectomy
C Bakoyiannis1, G Karaolanis, D Moris
11st Department of Surgery, Vascular Surgery Unit, Laikon General Hospital, Medical School of Athens, Athens, Greece - drgikaraolanis@gmail.com.
Insights
Elevated homocysteine (Hcy) levels are linked to restenosis after carotid endarterectomy (CEA). This study found Hcy significantly correlates with restenosis and complicated plaque formation within 24 months post-surgery.
Area of Science:
- Vascular Surgery
- Cardiovascular Disease
- Biomarkers
Background:
- Homocysteine (Hcy) is a potential risk factor for vascular diseases.
- Carotid endarterectomy (CEA) is a procedure to prevent stroke in patients with carotid artery stenosis.
- Restenosis after CEA remains a clinical concern.
Purpose of the Study:
- To investigate the role of serum homocysteine (Hcy) as a clinical risk factor for restenosis following carotid endarterectomy (CEA).
- To assess the correlation between Hcy levels and the development of restenosis and atheromatous plaque characteristics post-CEA.
Main Methods:
- Prospective study of patients undergoing CEA with venous patch closure.
- Measurement of serum Hcy levels pre- and post-operatively.
- Follow-up evaluations for restenosis at 3, 6, 9, 12, 18, and 24 months.
Main Results:
- Restenosis occurred in 7.25% of patients within 24 months.
- Elevated serum Hcy levels were significantly correlated with restenosis (P=0.010).
- Hcy levels also significantly correlated with the presence of complicated atheromatous plaque (P=0.005).
Conclusions:
- Serum homocysteine levels are a significant predictor of restenosis after carotid endarterectomy.
- Hcy is statistically associated with the presence of complicated atheromatous plaque.
- These findings highlight Hcy as a potential therapeutic target to reduce restenosis risk post-CEA.
Aim:
Homocysteine (Hcy) has been identified as a potential risk factor for vascular disease. This study investigates the role of serum Hcy as clinical risk factor for restenosis after carotid endarterectomy (CEA).
Methods:
In a prospective design, we studied patients who underwent carotid endarterectomy with venous patch closure technique with respect to alterations of Hcy levels pre and postoperatively. The patients studied were subjected to reevaluation for possible restenosis at time-points 3, 6, 9, 12, 18 and 24 months postoperatively.
Results:
Fifty-three symptomatic and 37 asymptomatic patients with stenosis of internal carotid artery >70% were studied. Restenosis appeared in 7.25% of the patients within 24 months postoperatively. Hcy was the only parameter that correlated significantly with the presence of restenosis (P=0.010) and the presence of type VI (complicated) atheromatous plaque (P=0.005) within 24 months postoperatively.
Conclusion:
Hcy levels were found to be statistically significantly correlated with both the presence of complicated atheromatous plaque and the degree of internal carotid artery restenosis after CEA.
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