Management of Patients Experiencing Restenosis After Carotid Endarterectomy or Stenting

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Management of Patients Experiencing Restenosis After Carotid Endarterectomy or Stenting

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease (DO NOT EDIT)

Restenosis After Carotid Endarterectomy or Stenting

Class III (No Benefit)

"1. Reoperative CEA or CAS should not be performed in asymptomatic patients with less than 70% carotid stenosis that has remained stable over time. (Level of Evidence: C) "

Class IIa

"1. In patients with symptomatic cerebral ischemia and recurrent carotid stenosis due to intimal hyperplasia or atherosclerosis, it is reasonable to repeat CEA or perform CAS using the same criteria as recommended for initial revascularization(Level of Evidence: C)"

"2. Reoperative CEA or CAS after initial revascularization is reasonable when duplex ultrasound and another confirmatory imaging method identify rapidly progressive restenosis that indicates a threat of complete occlusion (Level of Evidence: C)"

Class IIb

"1. In asymptomatic patients who develop recurrent carotid stenosis due to intimal hyperplasia or atherosclerosis, reoperative CEA or CAS may be considered using the same criteria as recommended for initial revascularization. (Level of Evidence: C)"

References

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