Background/purpose The optimal management of carotid artery in-stent restenosis is not well described. Reported here is experience with cutting balloon angioplasty in six patients with long-term follow-up.

Methods A single-operator, prospective, elective, carotid artery stent registry (n = 296) was reviewed for patients who underwent retreatment for early (within 6 months) in-stent restenosis after carotid artery stenting (CAS). Six patients were identified. All were treated with cutting balloons. Procedural outcome and long-term follow-up was collected from the registry and hospital records.

Results Cutting balloon angioplasty was technically successful and uncomplicated in all six treated patients. The procedure was durable in 5/6 (range of follow-up 3–36 months, median = 24 months).

Conclusions Cutting balloon angioplasty is an effective initial treatment for severe carotid in-stent restenosis.