Frequency of restenosis after carotid endarterectomy

Abstract

Introduction: Carotid artery restenosis is a significant long-term complication of carotid endarterectomy. Carotid artery restenosis is the result of neointimal hyperplasia in the early postoperative period or recurrent atherosclerotic lesions in the following period. Numerous studies have incriminated several risk factors as predisposing conditions for restenosis. The definite role of each predisposing factor, however, is still widely debated. Aim: Investigation of frequency and risk factors for restenosis after carotid endarterectomy. Material and methods: Data of 295 patients who underwent carotid endarterectomy was reviewed between 2008 and 2010. Postoperative duplex studies were performed on control examinations in the following period between 2011 and 2019. Retrospective analysis was performed to assess the effect of demographic, clinical and laboratory characteristics of patients on the development of restenosis after carotid endarterectomy. Results: Restenosis occurred in 76 (26%) patients after carotid endarterectomy, with the highest incidence during the third (33%) and fourth (25%) year of follow-up. Patients with diabetes (p = 0.048) and peripheral arterial occlusive disease (p = 0.041) had significant statistical correlation with the occurrence of restenosis, as well as parameters of lipid status - cholesterol values (p = 0.025), serum low-density lipoprotein (p = 0.036) and non highdensity lipoprotein (p = 0.041). Conclusion: The results of our study confirm the significant role of atherosclerotic risk factors in the development of carotid artery restenosis in the later postoperative period. More frequent monitoring and control of systemic risk factors in these patients is necessary in order to prevent the development of carotid artery restenosis.