Postoperative carotid artery restenosis following endarterectomy occurred in 15% of patients, with a higher rate observed in women (25%) compared to men (9%).
Cohort (n=227)
What is the incidence and natural history of recurrent carotid artery stenosis following endarterectomy?
Postoperative carotid restenosis occurs in approximately 15% of patients, predominantly within the first year and significantly more often in women, likely due to myointimal hyperplasia.
Spectral analysis was used to examine 257 carotid arteries in 227 patients who had undergone carotid endarterectomy at 1, 3, 6, and 12 months after surgery and annually thereafter. Routine intraoperative completion angiography ensured that the operations were technically satisfactory. Postoperative restenoses were identified in 38 patients (15%). In 23 arteries (9%), the restenosis exceeded a 50% diameter reduction while in 15 arteries (6%) the stenosis was less than 50% of the diameter. Restenosis developed in 24/96 women (25%) and 14/161 men (9%). Twenty-nine (70%) stenotic lesions occurred within 12 months. In three patients early lesions regressed. Reoperation with patch angio-plasty was required in six patients. When the 219 carotid arteries that remained widely patent were compared to the 38 that restenosed , no differences were noted for age, diabetes mellitus, hypertension, smoking, or degree of preoperative stenosis. Early stenotic lesions appear to be due to myointimal hyperplasia, which is probably platelet mediated. The predominant female sex distribution may be explained by differences in platelet responsiveness in men and women.
Thomas et al. (Sun,) conducted a cohort in Carotid artery stenosis (n=227). Carotid endarterectomy was evaluated on Postoperative restenosis. Postoperative carotid artery restenosis following endarterectomy occurred in 15% of patients, with a higher rate observed in women (25%) compared to men (9%).