Recurrent @entity543 : results of the asymptomatic XXXX study.

@entity1 @entity64 @entity66 @entity2286 @entity2998 @entity850 @entity543
BACKGROUND AND PURPOSE: We sought to determine the incidence of recurrent @entity543 in @entity1 in the Asymptomatic @entity2998 Study (ACAS) who had undergone carotid endarterectomy and were prospectively followed with Doppler ultrasound for up to 5 years. METHODS: The ACAS database was interrogated to determine the rate of recurrent @entity543 (>/=60%) based up angiogram-validated Doppler data, with a 90% and a 95% positive predictive value, as well as information concerning the technologists' interpretation of percent @entity850 . These 3 parameters are reported for each of 3 time intervals: within 3 months of operation ( @entity66 ), between 3 and 18 months (early restenoses), and between 18 and 60 months (late restenosis). RESULTS: Of the 825 @entity1 randomized to the surgical arm of the study, 720 actually underwent carotid endarterectomy, and 645 had complete ultrasound data. The aggregate incidence of residual and recurrent @entity543 for all time intervals ranged from 12.7% to 20.4%, depending on the positive predictive value confidence level desired. @entity66 occurred in 4.1% to 6.5%; true, early restenosis was found in 7.6% to 11.4%; and late restenosis occurred in 1.9% to 4.9%. None of the traditional risk factors showed a statistically significant effect on recurrent @entity850 . The use of patch angioplasty closure reduced overall risk of restenosis from 21.2% to 7.1%, from 16.7% to 4.6%, and from 27.4% to 8.2%, depending on the @entity2286 confidence level desired (P<0.001). Of the 136 @entity1 judged to have recurrent @entity850 , only 8 (5.9%) underwent reoperation (only 1 for symptoms). There was no correlation between late @entity64 and recurrent @entity850 . CONCLUSIONS: Carotid endarterectomy is a durable procedure with a low rate of true restenosis, particularly when patch angioplasty is used to close the arteriotomy.
