<b>Determinants of In-Stent Restenosis After Carotid Angioplasty</b>: A Case-Control Study

Setacci, Carlo; Pula, Giorgio; Baldi, Irene; Donato, G de; Setacci, Francesco; Cappelli, Alessandro; Pieraccini, Massimo; Cremonesi, Alberto; Castriota, Fausto; Neri, Eugénio

doi:10.1583/1545-1550(2003)010<1031:doirac>2.0.co;2

Cited by 41 publications

(30 citation statements)

References 35 publications

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“…52 Finally, there still is the need for identifying specific risk factors for the development of restenosis after CAS. Some studies have identified advanced age, 18 female gender, 18 hyperglycemia, 53 previous treatment with a CEA, 54 and increased serum levels of acute-phase reactants 21 as potential risk factors for the development of a restenosis after CAS; however, the definitive role of these factors remains to be elucidated in larger trials.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting

Gröschel

Riecker

Schulz

et al. 2005

Stroke

135

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Background and Purpose-Carotid angioplasty and stenting (CAS) has emerged as a potential alternative to endarterectomy (CEA) for the treatment of carotid artery disease. Aside from the periprocedural complication rates, the benefits of CAS will be affected by the incidence of recurrent carotid stenosis. Methods-We conducted a systematic analysis of all peer-reviewed studies reporting on the rate of restenosis (Ն50%) after CAS based on duplex ultrasound or angiography that were published between January 1990 and July 2004. We identified 34 studies that reported on a total of 4185 patients with a follow-up of 3814 arteries over a median of 13 months (range, 6 to 31 months).The ultrasound criteria and the lower thresholds for defining a recurrent stenosis were very heterogeneous. Results-The cumulative restenosis rates after 1 and 2 years were Ϸ6% and 7.5% in those studies, which used a lower restenosis threshold Ն50% to 70% and Ϸ4% in the first 2 years after CAS in those studies, which used a lower restenosis threshold Ͼ70% to 80%. Conclusions-In reviewing the current literature, the early restenosis rates after CAS compare well with those reported for CEA. However, this analysis of the peer-reviewed literature also indicates that the early restenosis rates after CAS might be higher than previously suggested in observational surveys. Therefore, an active follow-up of all stented arteries seems to be warranted. Moreover, the bulk of endovascular data are derived from small studies with short follow-up periods so that the long-term durability of CAS still needs to be established in large trials.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting

Gröschel

Riecker

Schulz

et al. 2005

Stroke

135

View full text Add to dashboard Cite

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“…Stent restenosis is one of the most important factors affecting the long-term effects of carotid stent angioplasty (Khan et al, 2003;Setacci et al, 2003;Gurm et al, 2008;Moreira et al, 2012). Restenosis is caused by the hyperplasia of the smooth muscle cells or endomembrane, rather than by the atherosclerosis plaque.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects and safety review of self-expanding stent surgery for extracranial carotid artery stenosis treatment

Zhu¹,

Fang²,

Wang³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. This study aimed to investigate the clinical effects and safety review of self-expanding stent surgery in the treatment of extracranial carotid artery stenosis. Seventy-eight patients with carotid artery stenosis were applied with the self-expanding stent for endovascular interventional therapy. Eighty-one stents were implanted into 80 blood vessels of the 78 patients, in which protective umbrellas were used in 56 cases, and the success rate of stent implantation was 100%. The stenosis degree decreased from the preoperative (86.72 ± 9.5%) to the postoperative (13.43 ± 5.62%) stage, and the blood peak velocity of the stenosed vessels decreased from 189.58 ± 13.5 to 83.73 ± 5.61 cm/s. Transient blood pressure and heart rate decreases occurred in 21 cases, continuously low blood pressure and heart rate decreasing occurred in 29 cases, and acute occlusion of the ipsilateral middle cerebral artery occurred in 1 case, which was resolved through thrombolysis and thrombus breaking in time. Overperfusion symptoms were observed in 13 cases, although without serious complications such as cerebral hemorrhage. The follow-up period continued for 6-32 months, and ultrasonography revealed that Evaluation of self-expanding stent surgery 77 cases had no stent-restenosis, while 1 case had restenosis. The application of self-expanding stents had good clinical effects, with fewer complications and higher safety for the treatment of extracranial carotid artery stenosis.

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“…The in-stent stenosis rate for bare metal stents in larger studies has been estimated at 4-5% 15 . Maras et al 13 reviewed 20 patients of traumatic pseudoaneurysms treated with covered stent grafts and found a 15% occlusion rate.…”

Section: Casementioning

confidence: 99%

In-Stent Stenosis Following Covered Stent-Graft Placement

Flood

Bussiére

Teefy

et al. 2009

Can. j. neurol. sci.

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Internal carotid artery (ICA) covered stent-grafts are increasingly utilized for the endovascular management of traumatic carotid pseudoaneurysms 1 " 9 , carotid-cavernous fistulas 1012 , large petrous/cavernous carotid aneurysms 12 and carotid blow-out syndrome 7 . Early covered stent grafts were selffabricated using polytetrafluoroethylene or autologous vein mounted onto bare metal stents. Pre-mounted balloon expandable or self-expanding stent-grafts are now commercially available. Covered stents provide an alternate treatment option for high surgical risk or inaccessible lesions or when observation and anticoagulation are less than desirable. Potential advantages of covered stent grafts include minimal invasiveness, shorter hospital stays, lower cost and less post-procedural pain. Caution in the application of this relatively new technology and careful follow-up are required, however, as is illustrated by two patients with internal carotid artery stenosis following covered stent-graft placement. Case IA 24-year-old previously healthy right-handed woman was the belted driver in a vehicle roll-over. She sustained multiple injuries including fractures of the odontoid process of C2 and the left transverse process of C7. A computed tomogram (CT) head performed at the time of admission was unremarkable. The patient was sedated, intubated and treated with hypothermia according to the institutional protocol. As the sedation dissipated 24-hours later, the patient was found to be aphasic with mild right-sided face and arm weakness. A repeat CT head demonstrated a subacute left fronto-temporal infarct and CT angiography revealed left internal carotid artery (ICA) occlusion, presumed to be secondary to arterial dissection. Antiplatelet therapy was initiated at this time.The patient made a good functional recovery with significant improvement in speech and complete recovery of motor function. A one-month follow-up CT angiogram demonstrated recanalization of the left ICA but development of a pseudoaneurysm at the level of the first cervical vertebrae. Serial noninvasive angiography over three months demonstrated progressive enlargement of the pseudoaneurysm and consequently the patient was referred for endovascular management to prevent its continued expansion and decrease the future risk of a recurrent ischemic event.Given the angio-architecture of the pseudoaneurysm, covered stent graft placement or vessel occlusion were considered as the safest and effective treatment options. An approach preserving

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Determinants of In-Stent Restenosis After Carotid Angioplasty: A Case-Control Study

Cited by 41 publications

References 35 publications

Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting

Systematic Review of Early Recurrent Stenosis After Carotid Angioplasty and Stenting

Clinical effects and safety review of self-expanding stent surgery for extracranial carotid artery stenosis treatment

In-Stent Stenosis Following Covered Stent-Graft Placement

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