Recurrent carotid artery stenoses

Abstract

Recurrent stenoses belong to the gravest complications after interventions of patency restoration of carotid arteries. According to the clinical course and the histological picture of the arterial site after intervention, recurrent stenoses are classified as either early or late.
The term of early restenosis refers to arterial narrowing which occurs within the first two years following the procedure. In this period, recurrence of stenosis is caused by intimal hyperplasia. This type of stenosis bears a low risk of neurological complications.
Late stenoses occur in the later period after the initial procedure. They do not differ from the primary lesions on pathomorphological grounds, and their risk of causing neurological complications is similar to that of the primary arterial narrowings. Stenoses bearing high risk of complete occlusion of carotid artery or provoking neurological symptoms necessitate reoperation. Although long-term results of repeated operations are similar to those of primary interventions, higher risk of intra- and postoperative complications should be taken into account. The role of endovascular interventions in primary and secondary arterial stenoses remains not unequivocally determined.