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Home > Vascular Annual Meeting^® > PP101. Carotid Angioplasty and Stenting: Treatment...

PP101. Carotid Angioplasty and Stenting: Treatment of Post CEA Restenosis Is at Least as Safe as Primary Stenosis Treatment

Jan Albert Vos1, Gert J. De Borst2, Tim Th C. Overtoom1, Jean Paul P.M. de Vries1, Eric D.W. van de Pavoordt3, Pieter Zanen2, Rob G.A. Ackerstaff3
1St Antonius Hospital, Nieuwegein, Netherlands; 2University Medical Center Utrecht, Utrecht, Netherlands; 3St Antonius Ziekenhuis, Nieuwegein, Netherlands

OBJECTIVES: To compare Transcranial Doppler (TCD) and outcome of Carotid Angioplasty and Stenting (CAS) in post Carotid Endarterectomy (CEA) restenoses versus primary atherosclerotic stenoses. Retrospective analysis of prospectively accumulated database.

METHODS: 812 CAS procedures were divided into two groups: group 1) 72 restenoses; group 2) 740 primary stenoses. Clinical endpoints: cerebral ischemic events and death. TCD endpoints: numbers of isolated micro emboli and micro embolic showers, during five procedural phases. Mann-Whitney U test and χ2-test were used. To test for independence of variables the Mantel-Haentzel test and univariate regression analysis were performed. p<.05 was regarded as statistically significant.

RESULTS: Groups were evenly matched for demographic data (median age: 70 vs. 71 years, male: 44/72 [61%] vs. 525/740 [71%], symptomatic 14/72 [19%] vs. 147/740 [20%]). There were 7 fatalities (0.9 %), 10 major (1.2%) and 21 minor (2.6%) strokes, all occurred in group 2 (p=0.049), which was independent from CPD use. After correction for the difference in CPD use between groups (17/72 [24%] vs. 345/740 [47%]), no statistically significant differences were found in numbers of isolated emboli and embolic showers in any of the procedural phases, nor for the entire procedure. No statistically significant differences were found for TCD data between early and late restenoses analyzing 2 and 3 years as cut off points.

CONCLUSIONS: CAS for restenosis after CEA has a complication rate lower than primary CAS; time interval between CEA and CAS did not influence micro embolic load.

AUTHOR DISCLOSURES: J. Vos, None; G.J. De Borst, None; T.T.C. Overtoom, None; J.P.M. de Vries, None; E.D.W. van de Pavoordt, None; P. Zanen, None; R.G.A. Ackerstaff, None.