[Eversion endarterstentectomy for treatment critical in-stent restenosis after Wallstent carotid stenting]

Acute stroke is the second cause of death in Russia. Currently, carotid endarterectomy remains the 'gold standard' for stroke prevention in patients with stenosis of the internal carotid arteries. Endovascular treatment of atherosclerotic lesion of the carotid bifurcation claims to be an alternative to open reconstructions. The problem of restenosis after both types of intervention remains a significant problem at the moment. According to the literature, massive calcification of an atherosclerotic plaque is a predictor of a greater number of complications during stenting and the impossibility of achieving technical success due to residual stenosis and stent deformation in the long-term period. We summarized the literature data regarding the results of stenting in patients with calcified plaques, risk factors for restenosis, and analyzed the published results of open surgical interventions for in-stent restenosis after endovascular procedures. We also present our own clinical case of sequential bilateral eversion carotid endarterstenectomy in a patient with critical in-stent restenosis of the internal carotid arteries after Wallstent stent implantation.