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Primary Stenting for Recurrent Stenosis Following Carotid Endarterectomy

Published online by Cambridge University Press:  02 December 2014

Miguel Bussière ,
David M. Pelz  and
Stephen P. Lownie
Miguel Bussière*
Affiliation:
Divisions of Neurology and Neuroradiology, The Ottawa Hospital, Ottawa
David M. Pelz
Affiliation:
Department of Medical Imaging, London Health Sciences Centre, London, Ontario
Stephen P. Lownie
Affiliation:
Department of Medical Imaging, London Health Sciences Centre, London, Ontario Department of Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario
*
Neurology and Interventional Neuroradiology, C2, Room 2174, Civic Campus, The Ottawa Hospital, 1053 Carling Avenue, Ottawa, Ontario, K1Y 4E9, Canada
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Abstract:

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Background:

Carotid angioplasty and stenting is an accepted alternative treatment for severe restenosis following carotid endarterectomy. Balloons may not be required to effectively treat these lesions, given their altered histopathology compared to primary atherosclerotic plaque and tendency to be less calcified. Primary stenting using self-expanding stents alone may, therefore, be a safe and effective treatment for restenosis post-carotid endarterectomy.

Methods:

We review our experience in the treatment of 12 patients with symptomatic severe restenosis following carotid endarterectomy with primary stent placement alone.

Results:

Self-expanding stent placement alone reduced the mean internal carotid artery stenosis from 85% to 29%. Average peak systolic velocity determined at the time of ultrasonography decreased from 480 cm/s at initial presentation to 154 cm/s post-stent deployment and further decreased to 104 cm/s at one year follow-up. The stented arteries remained widely patent with no evidence of restenosis. A single peri-procedural ipsilateral transient ischemic event occurred. There were no cerebral or cardiac ischemic events recorded at one year of follow-up.

Conclusions:

In this series, primary stent placement without use of angioplasty balloons was a safe and effective treatment for symptomatic restenosis following carotid endarterectomy.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 36 , Issue 3 , May 2009 , pp. 332 - 335
Copyright
Copyright © The Canadian Journal of Neurological 2009

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