Recurrent stenosis after carotid endarterectomy
A. D. Callow
The true incidence of recurrent carotid stenosis is unknown. Most reports
provide only anecdotal data. Reported incidences, which range from 0.6% to
9.8%, reflect the care with which the search for recurrent stenosis was
made by individual reporters. Early restenosis occurring within less than
24 months is characterized by a fibrous hyperplastic reaction, whereas
stenoses occurring beyond this time are usually caused by typical
atherosclerotic lesions. Although no clear risk factors can be identified,
surgical trauma and inadequate endarterectomy are likely predisposing
causes. Reoperation is technically more difficult and a patch graft,
preferably vein, is often necessary. Careful postoperative evaluation and a
search for the possibility of recurrent stenosis is recommended, especially
in view of the increasing frequency of prophylactic carotid endarterectomy.
