REVIEWS  CAROTID ARTERY STENTING: AN UPDATE 

The Journal of Cardiovascular Surgery 2006 April;47(2):153-60

Copyright © 2006 EDIZIONI MINERVA MEDICA

lingua: Inglese

Management of carotid restenosis

Lal B. K., Hobson R. W. II

Division of Vascular Surgery, Department of Surgery UMDNJ-New Jersey Medical School, Newark, NJ, USA

Carotid endarterectomy is the preferred method for cerebral revascularization in patients with symptomatic and asymptomatic high-grade extracranial carotid artery stenosis. Carotid artery stenting has recently emerged as a less invasive alternative to endarterectomy. Carotid stenting has been demonstrated to be technically feasible and safe in high-risk patients with current data indicating clinical equipoise with respect to endarterectomy. It is clear that carotid stenting will continue to be performed at increasing rates after these encouraging outcomes. Therefore, it is anticipated that there will be a corresponding increase in the number of in-stent restenosis cases. Considerable controversy exists regarding the clinical significance, natural history, threshold for management, and appropriate intervention of recurrent carotid stenosis after endarterectomy and after stenting. This review analyses current information on this important clinical problem and presents evidence-based recommendations for the diagnosis and management of recurrent carotid stenosis.