Long-term results of endovascular treatment for recurrent stenosis of the carotid arteries

Abstract

Background. Percutaneous angioplasty of recurrent stenosis of the carotid arteries with simultaneous stent implantation is an alternative to surgical intervention. The observations made and the long-term effects of the above-mentioned treatment are the subject of this paper.
Material and methods. In 2001-2004, in 20 patients with recurrent stenosis of the carotid arteries, angiography with stent implantation was performed after reboring. In the control imaging (DSA and Dopplerduplex), the technical effect of the intravascular procedure was assessed. Special attention was paid to stent dilatation, as well as to the spectrum and speed of blood flow in the carotid arteries. Nineteen patients were put under observation for 18–24 months, with control tests every 90 days.
Results. One patient died shortly after the intravascular procedure. During the long-term observation period, a haemodynamically significant recurrence of stenosis was observed in 3 of 19 patients. In 2 of the patients, an additional stent was implanted. Treatment of the third patient was limited to expansion of the constricted stent. The rest of the patients displayed neither clinical nor radiological signs of carotid artery stenosis.
Conclusions. Intravascular procedures are an effective and safe method of treating recurrent stenosis of the internal carotid artery. After angioplasty and stent implantation, patients require periodic ultrasound assessment due to the possibility of stenosis recurrence, which most often affects the area of the common carotid artery neighbouring the proximal segment of the implanted stent.