Recurrent Atherosclerotic Obstruction of the Internal Carotid Artery Five Years After Endarterectomy

A patient is described in whom an obstructive atherosclerotic plaque recurred in the cervical portion of the internal carotid artery five years after endarterectomy. The lesion appeared to be a new formation of atheromatous material contiguous to the site of the previous arteriotomy and resulted in neurological symptoms almost identical to those experienced by the patient five years before. This case suggests that the treatment of cerebral ischemia by surgical removal of stenotic lesions in the extracranial cerebral arteries may produce only temporary relief of symptoms and emphasizes the need, following endarterectomy, for medical therapy of the underlying atherosclerotic disease.