Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting

Abstract

Carotid angioplasty and stenting (CAS) has emerged as an alternative to endarterectomy (CEA) for the treatment of carotid artery disease. However, the benefit of CAS is determined by the rate of recurrent carotid stenosis. The authors conducted an analysis of peer-reviewed studies that reported the rate of restenosis exceeding 50% after carotid angioplasty and stenting as determined by duplex ultrasound or angiography. They found 34 studies that met the criteria in which 4185 patients were reported and a follow-up of 3814 arteries occurred over a median of 13 months. The cumuiative restenosis rates were about 6%; and 7.5%9 after 1 and 2 years with a stenosis threshold of between 50% and 70%. The rate was 4% after 2 years in studies with a restenosis threshold of more than 70% to 80%. Although restenosis rates after CAS compare well with those reported for CEA, it appears that the rate might be higher than observational studies have suggested. Follow-up on all stented arteries is advised.