Incidence of Repeat Blockage of Carotid Artery Low
(HealthDay News) – Rates of restenosis and occlusion do not differ between patients who received carotid artery stenting (CAS) or carotid endarterectomy (CEA) for the treatment of carotid stenosis, according to a study presented at the American Heart Association's International Stroke Conference, held from February 1–3 in New Orleans.
Brajesh K. Lal, M.B.B.S., of the University of Maryland Medical School in Baltimore, and colleagues studied 2,191 patients with either symptomatic or asymptomatic carotid stenosis. Patients received treatment within 30 days of randomization in the Carotid Revascularization Endarterectomy versus Stenting Trial and had an ultrasound reviewed at the Core Lab. Restenosis, occlusion, and repeat revascularization were assessed at one, six, 12, and 24 months post-randomization. Hemodynamically significant restenosis (a ≥70 percent diameter reduction) was defined by a peak systolic velocity of ≥300 cm/second on standardized duplex ultrasonography (DUS). Occlusion was described as an absence of flow within the target artery on DUS, and repeat revascularization was assessed by having any additional procedure (CEA, angioplasty, or CAS) performed on the index artery.
The researchers followed 1,086 patients who received CAS and 1,105 who received CEA. Over two years of follow-up, 113 patients developed restenosis (56 in the CAS group and 57 in the CEA group) and eight developed an occlusion (three in the CAS group and five in the CEA group). The combined restenosis-occlusion rate was 6.0 percent for those receiving CAS and 6.3 percent for those receiving CEA. Of the 2,191 patients, 43 underwent repeat revascularization (20 CAS and 23 CEA; P = 0.69). Of the 120 patients with restenosis or occlusion, 13 patients had a stroke (four CAS and nine CEA); one of the CAS strokes and five of the CEA strokes occurred after restenosis was detected.
"Restenosis and occlusion were infrequent and similar up to two years following CAS or CEA among 2,191 patients," the authors write.
Several authors disclosed financial ties to medical device companies.