Recurrent carotid stenosis. Incidence and management

The actual incidence of recurrent carotid occlusive disease is not known. From January 1974 through December 1984, fifty-four patients underwent at least one second carotid endarterectomy or reconstructive procedure at St. Thomas Hospital in Nashville. Five patients required a third carotid operation. This retrospective study examines case reports, risk factors, patient presentation, interval of recurrence, and pathology involved. Surgical techniques and results are described. Complications occurred in six patients undergoing a total of 66 operations for an overall incidence of 9 per cent. Thrombosis was minimized by the use of antiplatelet drugs. Follow-up of patients ranged from one to 84 months. Four main causes for restenosis are discussed.