Operative management of carotid artery in-stent XXXX : first experiences and duplex follow-up.

@entity1 @entity64 @entity1373 @entity2998 @entity256 @entity432
OBJECTIVES: @entity2998 ( @entity2998 ) may be comparable to Carotid Endarterectomy (CEA) as a durable and effective procedure in @entity64 prevention. Concern remains about the incidence of @entity256 after stenting and its management. We evaluated the surgical management of @entity256 after @entity2998 . DESIGN: prospective study. METHODS: between December 1997 and April 2001, 217 @entity2998 procedures were performed in 217 @entity1 (155 @entity1 and 62 @entity1 ; age 70 years +/- 8.2). After a mean of 8 months post-stenting four @entity1 (two symptomatic, two asymptomatic with @entity432 ) with severe @entity256 (90-99%) had surgical reintervention. RESULTS: standard CEA with removal of the stent was performed in all four @entity1 . No major complications occurred. Intima @entity1373 showed to be the predominant mechanism leading to in-stent @entity256 . All four surgically treated @entity1 remained asymptomatic and without recurrent @entity256 over a mean follow-up time of 13 months (range 3-20 months). CONCLUSION: the optimal treatment of in-stent @entity256 has yet to be defined, but standard CEA with removement of the stent appears to be feasible.
