Recurrent carotid stenosis: prevention, surveillance, and management

Carotid endarterectomy has come under closer scrutiny, perhaps more than any other surgical procedure. Many studies have shown excellent early results; however, recurrent carotid stenosis is a recognized complication arising in the postoperative follow-up period. The local and systemic factors that may contribute to recurrent stenosis are reviewed. The results of noninvasive postoperative surveillance are examined, and a rational schedule is proposed. Finally, the diagnosis of recurrent stenosis and its surgical management with redo endarterectomy are discussed.