Key result
Redo endarterectomy or graft reconstruction are effective for treating symptomatic or high-grade asymptomatic carotid restenosis, while eversion endarterectomy is recommended to prevent restenosis.
Redo endarterectomy or graft reconstruction remain the most effective treatments for severe recurrent carotid stenosis, with eversion endarterectomy preferred for initial procedures to prevent restenosis.
May guide selected carotid restenosis cases; leaves open need for prospective trials before practice change.
Carotid restenosis has been a well-recognized, though not well-understood, long-term complication of carotid endarterectomy. Various factors contribute to recurrent stenosis, but the chief cause is technical faults during the primary procedure. Redo endarterectomy or graft reconstruction are the traditional and most effective procedures for treating symptomatic or high-grade (> 80%) asymptomatic restenotic lesions. To reduce the potential for carotid restenosis, eversion endarterectomy is recommended as the technique of choice for de novo carotid disease treatment. Angioscopy is useful in detecting correctable technical errors that could predispose to restenosis.
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D. Raithel (1996) conducted a review in Carotid restenosis. Redo endarterectomy or graft reconstruction was evaluated. Redo endarterectomy or graft reconstruction are effective for treating symptomatic or high-grade asymptomatic carotid restenosis, while eversion endarterectomy is recommended to prevent restenosis.
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