Carotid artery interventions for restenosis after prior stenting: is it different from interventions of de novo lesions? Results from the carotid artery stent (CAS)--registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)

Clin Res Cardiol. 2010 Dec;99(12):809-15. doi: 10.1007/s00392-010-0188-9. Epub 2010 Jul 2.


Objective: To compare characteristics and outcome of patients with re-stenoses after prior carotid artery stenting (CAS) treated with repeat carotid interventions (Re-CI) with CAS for de novo lesions.

Background: The treatment of re-stenosis is a major problem in vascular interventions. Patients with re-stenoses after prior CAS treated with Re-CI are not well defined.

Methods: We analyzed data from the prospective ALKK CAS Registry.

Results: Out of 3,817 CAS procedures 95 were intended in 93 patients (2.5%) for a restenosis after prior CAS and 3,722 CAS in 3,655 patients (97.5%) for a de novo stenosis. There was no difference in age (p = 0.302) or distribution of gender (p = 0.545) between the two groups. Patients treated for a restenosis after CAS were less likely to be treated for a symptomatic lesion (22.7 vs. 40.1%, p = 0.001). Coronary heart disease (p = 0.017), peripheral arterial disease (p < 0.001) as well as diabetes mellitus (p = 0.004) were more prevalent in the restenosis group. Lesions were less complicated in restenosis patients, with less ulcers (7.4 vs. 19.9%, p = 0.003) and less severe calcifications (7.4 vs. 23.6%, p < 0.001). The intended interventions were more often not performed in the Re-CI group (9.5 vs. 3.3%; p = 0.001). In-hospital, the stroke or death rate was 0% in the Re-CI group as compared to 3.1% in the de novo group (p = 0.115).

Conclusions: Patients treated with Re-CI for repeat stenoses after prior CAS represent 2.5% of current CAS patients. Although representing a subgroup with more concomitant diseases, Re-CI seems to be associated with lower event rates as compared to CAS for de novo lesions.

MeSH terms

  • Aged
  • Carotid Stenosis / pathology
  • Carotid Stenosis / surgery*
  • Coronary Disease / epidemiology
  • Diabetes Mellitus / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / epidemiology
  • Recurrence
  • Registries
  • Retrospective Studies
  • Stents*
  • Stroke / epidemiology
  • Treatment Outcome