2019
DOI: 10.1016/j.jvs.2018.08.185
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The incidence of carotid in-stent stenosis is underestimated ≥50% or ≥80% and its clinical implications

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Cited by 17 publications
(8 citation statements)
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References 37 publications
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“…Doppler ultrasound is an excellent tool for the evaluation of this pathology, accurately monitoring the percentage of in-stent stenosis and the hemodynamic repercussion it represents. In-stent stenosis of 50% correlates with velocities of up to 225 cm/s and greater than 70% correlates with velocities of up to 350 cm/s [3].…”
Section: Descriptionmentioning
confidence: 92%
“…Doppler ultrasound is an excellent tool for the evaluation of this pathology, accurately monitoring the percentage of in-stent stenosis and the hemodynamic repercussion it represents. In-stent stenosis of 50% correlates with velocities of up to 225 cm/s and greater than 70% correlates with velocities of up to 350 cm/s [3].…”
Section: Descriptionmentioning
confidence: 92%
“…463 The incidence of carotid in-stent stenosis has been reported to vary between 1% and 30%, and might be slightly overestimated by conventional duplex ultrasound examination. 464,465 In the EVA-3S trial, recurrent carotid stenosis (>70% as defined by duplex ultrasound examination), was 11.1% at 2 years after CAS, significantly higher than after CEA (4.6%; P ¼ .001). 465 In contrast, a secondary analysis of the Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) trial showed no significant difference in restenosis or revascularization risk at 2 or 10 years after CAS (12.2%) and CEA (9.7%).…”
Section: Restenosis After Casmentioning
confidence: 99%
“…Evidence from recent studies suggests that criteria used for diagnosing an atherosclerotic stenosis of the carotid artery cannot be easily applied to in-stent restenosis. 464 This is due to the distinct biomechanical properties of the stented artery and its enhanced stiffness which results in increased flow velocity. Recent analysis proposed adjusted criteria for defining stenosis in stented arteries.…”
Section: Diagnosismentioning
confidence: 99%
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“…However, frankly, I am confused when other studies have suggested that a widely patent carotid stent will have higher baseline velocities than a widely patent native internal carotid artery. 2 If so, why should interventionalists believe that an ICA/CCA ratio >4.2 is consistent with >80% instent restenosis, when most consider a ratio >6.0 consistent with >80% stenosis in a native artery? I am a strong advocate for following the Society for Vascular Society guidelines; however, we also need to consider our own individual noninvasive vascular laboratory criteria.…”
Section: Duplex Ultrasound Surveillance After Transcarotid Artery Revascularization (Tcar) In Clinical Practicementioning
confidence: 99%