%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Gaudry, M.
%A Bartoli, J. M.
%A Bal, L.
%A Giorgi, Roch
%A De Masi, M.
%A Magnan, P. E.
%A Piquet, P.
%T Anatomical and technical factors influence the rate of in-stent restenosis following carotid artery stenting for the treatment of post-carotid endarterectomy stenosis
%D 2016
%L PAR00015080
%G ENG
%J Plos One
%@ 1932-6203
%M ISI:000383255900026
%N 9
%P e0161716
%R 10.1371/journal.pone.0161716
%U https://www.documentation.ird.fr/hor/PAR00015080
%V 11
%W Horizon (IRD)
%X Background Carotid arterystenting (CAS) has been advocated as an alternative to redo surgery for the treatment of post-carotid endarterectomy(CEA) stenosis. This study analyzed the efficacy of CAS for post-CEA restenosis, focusing on an analysis of technical and anatomical predictive factors for in-stent restenosis. Methods We performed a retrospective monocentric study. We included all patients who underwent CAS for post-CEA restenosis at our institution from July 1997 to November 2013. The primary endpoints were the technical success, the presence of in-stent restenosis > 50% or occlusion, either symptomatic or asymptomatic, during the follow-up period, and risk factors for restenosis. The secondary endpoints were early and late morbidity and mortality (TIA, stroke, myocardial infarction, or death). Results A total of 153 CAS procedures were performed for post-CEA restenosis, primarily because of asymptomatic lesions (137/153). The technical success rate was 98%. The 30-day perioperative stroke and death rate was 2.6% (two TIAs and two minor strokes), and rates of 2.2% (3/137) and 6.2% (1/16) were recorded for asymptomatic and symptomatic patients, respectively. The average follow-up time was 36 months (range, 6-171 months). In-stent restenosis or occlusion was observed in 16 patients (10.6%). Symptomatic restenosis was observed in only one patient. We found that young age (P = 0.002), stenosis > 85% (P = 0.018), and a lack of stent coverage of the common carotid artery(P = 0.006) were independent predictors of in-stent restenosis. Conclusion We identified new risk factors for in-stent restenosis that were specific to this population, and we propose a technical approach that may reduce this risk.
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