Predictors of restenosis after carotid endarterectomy: 17-year experience in a tertiary referral vascular center

Vasc Endovascular Surg. 2014 Apr;48(3):201-6. doi: 10.1177/1538574413518117. Epub 2014 Jan 9.

Abstract

Introduction: Carotid endarterectomy (CEA) is a well-established surgical technique in stroke prophylaxis. Long-term follow-up data on restenosis or recurrent neurological symptoms in Oriental patients are unclear.

Methods: Patients' notes from 1994 to 2011 were retrospectively reviewed and analyzed. A total of 301 cases of CEA were identified.

Results: A lower restenosis rate was associated with the use of patch and never smokers in both univariate and multivariate analysis. Use of patch and never smokers were also found to be significantly associated with longer restenosis-free survival. Use of patch and postoperative use of statin were associated with better overall survival in both univariate and multivariate analysis.

Conclusion: Use of patch and lack of smoking history are associated with less restenosis and longer restenosis-free survival. Use of patch and use of postoperative statin improves overall survival. Although restenosis after CEA is relatively common, reintervention was rarely necessary.

Keywords: carotid endarterectomy; recurrence; reintervention; restenosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carotid Stenosis / diagnosis
  • Carotid Stenosis / surgery*
  • Disease-Free Survival
  • Endarterectomy, Carotid / adverse effects*
  • Female
  • Hong Kong
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Proportional Hazards Models
  • Recurrence
  • Referral and Consultation
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Tertiary Care Centers*
  • Time Factors
  • Treatment Outcome

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors