This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Hugh A. Gelabert, MD; Sherif El-Massry, MD; Wesley S. Moore, MD

Arch Surg. 1994;129(6):648-654.

Abstract
Objectives
To review our results with carotid endarterectomy using primary closure and to study the incidence of true recurrence in this group of patients. A secondary objective was to review the effect of risk factors on recurrence of stenosis following carotid endarterectomy.

Design
Cohort study.

Setting
University hospital.

Patients
Over 3 years, 232 patients underwent 268 endarterectomies.

Indications
Transient ischemic attacks developed in 119 patients, asymptomatic stenosis in 108 patients, and stroke in 41 patients. One hundred fifty-seven patients (184 operations) qualified for late analysis by completing all aspects of follow-up.

Outcome Measures
Serial duplex scans recorded stenosis (>50% diameter reduction). Clinical evaluation identified transient ischemic attacks and stroke.

Results
Overall, 12 recurrent stenoses developed in the 184 patients available for study during a follow-up of 24 months (6.5% incidence of late stenosis). Of these 12 patients, only eight had either a normal completion angiogram or a normal carotid duplex scan within 3 months of surgery, thus qualifying for analysis as having developed true recurrent stenosis. True recurrent stenosis occurred in eight (4.3%) of 184 patients. Risk factor analysis did not reveal a statistically significant impact on recurrent stenosis, but several trends were identified. Gender and consumption of tobacco may predispose toward the development of recurrent stenosis.

Conclusion
Recurrent stenosis is sufficiently uncommon following primary closure to justify continued use of this technique. Patch angioplasty may be considered in women and smokers.

(Arch Surg. 1994;129:648-654)

Author Affiliations
From the Section of Vascular Surgery, University of California School of Medicine—Los Angeles.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Characteristic Sonographic Findings of Early Restenosis After Carotid Endarterectomy
Makihara et al.
J Ultrasound Med 2008;27:1345-1352.
ABSTRACT | FULL TEXT  

Decreased Antioxidant Vitamin Concentration May Be a Risk Factor for Recurrent Carotid Stenosis
Reid et al.
VASC ENDOVASCULAR SURG 2007;41:330-334.
ABSTRACT  

Factors Affecting Recurrent Carotid Stenosis
Liapis and Paraskevas
VASC ENDOVASCULAR SURG 2005;39:83-95.
ABSTRACT  

Recurrent Carotid Stenosis : Results of the Asymptomatic Carotid Atherosclerosis Study
Moore et al.
Stroke 1998;29:2018-2025.
ABSTRACT | FULL TEXT  

Carotid Recurrent Stenosis and Risk of Ipsilateral Stroke : A Systematic Review of the Literature
Frericks et al.
Stroke 1998;29:244-250.
ABSTRACT | FULL TEXT  

Treatment of Recurrent Carotid Disease: Report on a 12-Year Experience
Plestis et al.
VASC ENDOVASCULAR SURG 1997;31:693-702.
ABSTRACT  

Eversion Carotid Endarterectomy: A Safe, Advantageous Alternative to Conventional Carotid Endarterectomy: A Preliminary Report
Calaitges et al.
VASC ENDOVASCULAR SURG 1996;30:381-385.
ABSTRACT  

Cigarette Smoking Accelerates Carotid Artery Intimal Hyperplasia in a Dose-Dependent Manner
Petrik et al.
Stroke 1995;26:1409-1414.
ABSTRACT | FULL TEXT