Recurrent Versus Residual Carotid Stenosis

A sterile Doppler probe was used for intraoperative monitoring of the integrity of carotid endarterectomy of 125 vessels of 107 patients. Our objective was to reduce the contribution of residual carotid lesions to recurrent stenosis, which was evaluated by Doppler spectrum analysis in the early (less than 3 months, 66 arteries) and late (3-77 months, mean 32 months, 47 arteries) postoperative period. Intraoperative Doppler monitoring detected residual occlusion in six (4.8%) external carotid arteries and stenosis in ten (8.0%) internal carotid arteries permitting selected arteriography and correction of all significant lesions. Follow-up revealed one (1.5%) asymptomatic common carotid occlusion at 6 weeks and three (6.4%) asymptomatic internal carotid stenoses at 6, 10 and 25 months after operation. When compared to previous published experience, these results suggest that intraoperative correction of residual carotid obstruction detected by Doppler ultrasound may reduce the incidence of postoperative "recurrent" carotid stenosis.