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Updated: Jan 28, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

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Risk Factors for Restenosis After Carotid Revascularization: A Meta-Analysis of Hazard Ratios

Pavlos Texakalidis1, Andreas Tzoumas2, Stefanos Giannopoulos3

  • 1Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA.

World Neurosurgery
|March 2, 2019
PubMed

Insights

Diabetes, dyslipidemia, female gender, chronic kidney disease, hypertension, and smoking increase restenosis risk after carotid revascularization. Patch endarterectomy and symptomatic status decrease this risk.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Nephrology

Background:

  • Carotid artery restenosis occurs in 3%-30% of cases after carotid endarterectomy (CEA) or carotid artery stenting (CAS).
  • Restenosis can necessitate further monitoring and potential reoperation.
  • Identifying risk factors for restenosis is crucial for patient management.

Purpose of the Study:

  • To define demographic, clinical, and radiographic characteristics influencing restenosis risk after carotid revascularization.
  • To analyze risk factors for restenosis following both CEA and CAS procedures.

Main Methods:

  • A systematic review and meta-analysis of 18 studies involving 17,106 patients.
  • Utilized a random effects model to calculate hazard ratios (HRs) and confidence intervals (CIs).
  • Followed PRISMA guidelines for systematic reviews and meta-analyses.

Main Results:

  • Diabetes (HR, 1.68), dyslipidemia (HR, 1.77), female gender (HR, 1.50), chronic kidney disease (HR, 4.15), hypertension (HR, 1.99), smoking (HR, 1.65), and pretreatment stenosis >70% (HR, 1.04) significantly increased restenosis risk.
  • Patch endarterectomy (HR, 0.33) and symptomatic status in CAS (HR, 0.61) decreased restenosis risk.
  • Female gender and smoking were associated with restenosis after CEA, while hypertension was linked to restenosis after CAS.

Conclusions:

  • Key risk factors for carotid restenosis include diabetes, dyslipidemia, female gender, renal failure, hypertension, and smoking.
  • Patch endarterectomy and symptomatic presentation are associated with reduced restenosis risk.
  • Procedure-specific risk factors were identified, highlighting differences between CEA and CAS.
Abstract

Keywords:
Carotid artery stentingCarotid endarterectomyCarotid restenosisRisk factors

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