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Original research
Predictors of restenosis after carotid artery stenting in 241 cases
  1. Badih Daou,
  2. Nohra Chalouhi,
  3. Robert M Starke,
  4. Richard Dalyai,
  5. Adam Polifka,
  6. Kumar Sarkar,
  7. Pascal Jabbour,
  8. Robert Rosenwasser,
  9. Stavropoula Tjoumakaris
  1. Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr S I Tjoumakaris, Division of Neurovascular Surgery and Endovascular Neurosurgery, Department of Neurological Surgery, Thomas Jefferson University Hospital, 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107, USA; Stavropoula.Tjoumakaris{at}jefferson.edu

Abstract

Background Variable rates of restenosis after carotid artery stenting (CAS) have been reported, and few predictors have been suggested. Because CAS is being performed with increasing frequency, more data are needed to evaluate the rate and predictors of restenosis and possibly identify new risk factors for restenosis after CAS. The aim of this study was to analyze the rate and predictors of restenosis after CAS.

Methods 241 patients with carotid artery stenosis treated with stenting were analyzed retrospectively to identify patients who had restenosis after stenting. Univariate analysis and multivariate logistic regression were conducted to determine the predictors of restenosis.

Results Mean patient age was 67.5 years. 8.3% of patients who underwent CAS had carotid restenosis of ≥50% during follow-up. 3.7% of patients required retreatment. Mean duration from CAS to retreatment was 11 months. In multivariate analysis, the predictors of restenosis included history of cardiovascular disease (OR=8.88, p<0.001) and having a cerebrovascular accident (CVA) prior to stenting (OR=1.87, p=0.034). A higher percentage of preoperative carotid stenosis was associated with higher odds of restenosis in univariate analysis (p=0.04, OR stenosis ≥80%=5.7).

Conclusions Our results suggest that the rate of carotid restenosis after stenting is low. Patients with cardiovascular disease, patients who had a CVA prior to stenting, and patients with higher percentages of preoperative stenosis had higher odds of restenosis. Higher rates of restenosis should be kept in mind when opting for CAS in these patients.

  • Stenosis
  • Stent
  • Stroke

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