Abstract WP150: Restenosis after Carotid Endarterectomy
Background & Purpose: Restenosis after carotid endarterectomy (CEA) has been reported to be associated with ischemic stroke. The aim of the study was to evaluate the factors associated with re-stenosis after CEA.
Methods: Two-hundred and twelve CEAs were performed in 203 patients from January 2007 to March 2011 in our institution. In this cohort (n=202 CEAs, 194 pts), We included patients who had undergone serial imaging studies(CT angiogram (n=181) and/or ultrasonography (n=189)) postoperatively. Restenosis was defined as >50% stenosis on a CT angiogram and a >200 cm/sec Peak Systolic Velocity (PSV) on ultrasonography at the treated site. The factors associated with restenosis were analyzed retrospectively.
Results: Overall, restenosis occurred in 14 cases (7.1%) and its incidence was not significantly different between symptomatic and asymptomatic groups (4.6% versus 10.2%, respectively, P=0.13). There was no restenosis in the cases involving operation with a patch graft (n=9) and who took cilostazol perioperatively (n=26), but there was no significant difference(P=0.4,P=0.16, respectively). Pathological examination showed a significantly lower incidence of restenosis with a rich lipid core (P=0.004) and significantly higher incidence with calcification (P=0.001). In the symptomatic group, no restenosis occured in cases operated within 14 days after the most recent symptom, but without significance (P=0.37).
Conclusion: We showed that the restenosis rate was significant depending on the nature of carotid plaques. Restenosis was associated with unstable plaques. In symptomatic groups, restenosis occurred in relation to delayed surgery, suggesting a possible relation between carotid plaque stabilization and the development of restenosis after CEA.
- © 2012 by American Heart Association, Inc.