Carotid angioplasty and stenting versus redo endarterectomy for recurrent stenosis

Background: Carotid angioplasty and stent (CAS) is an alternative to redo carotid endarterectomy (RCEA) for recurrent carotid stenosis (RCS). The purpose of this study was to evaluate the outcomes of CAS in the treatment of RCS. Methods: In an 8-year period, all patients presenting for treatment of RCS were followed-up prospectively. Logistic regression analysis was performed to identify variables associated with unfavorable outcomes. Results: There were 45 CAS and 46 RCEA procedures performed in 75 patients. One patient in each group suffered a stroke. There were no deaths. The hospital length of stay was significantly shorter for CAS. Secondary recurrence was higher after RCEA (14% vs 6.1%) and failure to take beta-blockers was an independent predictor for multiple recurrences. Conclusions: CAS is a safe and effective method. to treat patients with RCS and may become the procedure of choice for this disease. (c) 2007 Excerpta Medica Inc. All rights reserved.