Carotid endarterectomy with stent removal in management of in-stent restenosis: a safe, feasible, and effective technique

Eur J Vasc Endovasc Surg. 2014 Jan;47(1):8-12. doi: 10.1016/j.ejvs.2013.10.011. Epub 2013 Oct 22.

Abstract

Introduction: The optimal treatment of in-stent restenosis (ISR) is not determined. We describe the efficacy of carotid endarterectomy (CEA) with stent removal in the management of symptomatic ISR.

Methods: A 72-year-old man presented with recurrent right limb weakness 8 months after carotid artery stenting. Digital substraction angiography showed severe ISR (almost 99%). CEA with stent removal was performed.

Results: A total of 41 cases was reviewed: periarterial inflammation was shown in 10.3% of patients; 92.9% had clear intima-media plane; and 85.4% had a good outcome. All patients remained stable at follow-up.

Discussion: CEA with stent removal appears to be a safe, feasible, effective, and durable therapeutic option.

Keywords: Carotid artery stenting (CAS); Carotid endarterectomy (CEA); In-stent restenosis (ISR); Stent removal.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angiography, Digital Subtraction
  • Angioplasty / adverse effects*
  • Angioplasty / instrumentation*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / surgery
  • Carotid Stenosis / therapy*
  • Device Removal*
  • Endarterectomy, Carotid*
  • Humans
  • Male
  • Recurrence
  • Stents*
  • Tomography, X-Ray Computed
  • Treatment Outcome