Journal of Vascular Surgery
Volume 46, Issue 5 , Pages 833-840 , November 2007

Patterns of in-stent restenosis after carotid artery stenting: Classification and implications for long-term outcome

Presented at VASCULAR 2007, Annual Meeting of the Society for Vascular Surgery, Baltimore, Md, June 7-10, 2007.

  • Brajesh K. Lal, MD

      Affiliations

    • Division of Vascular Surgery, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Department of Physiology, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Department of Biomedical Engineering, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Division of Vascular Surgery, St. Michaels Medical Center, Newark, NJ
    • Corresponding Author InformationReprint requests: Brajesh K Lal, MD, UMDNJ-New Jersey Medical School, 185 S Orange Ave, MSB-H570, Newark, NJ 07103.
    • ,
  • Elias A. Kaperonis, MD

      Affiliations

    • Division of Vascular Surgery, University of Athens, Athens, Greece.
    • ,
  • Salvador Cuadra, MD

      Affiliations

    • Division of Vascular Surgery, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Division of Vascular Surgery, St. Michaels Medical Center, Newark, NJ
    • ,
  • Indravadan Kapadia, PA

      Affiliations

    • Division of Vascular Surgery, St. Michaels Medical Center, Newark, NJ
    • ,
  • Robert W. Hobson II, MD

      Affiliations

    • Division of Vascular Surgery, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Department of Physiology, University of Medicine and Dentistry, New Jersey-New Jersey Medical School, Newark, NJ
    • Division of Vascular Surgery, St. Michaels Medical Center, Newark, NJ

Received 21 June 2007 ,Accepted 17 July 2007.

References 

  1. Hobson RW, Goldstein JE, Jamil Z, Lee BC, Padberg FT, Hanna AK, et al. Carotid restenosis: operative and endovascular management. J Vasc Surg. 1999;29:228–235discussion 235-8
  2. Hobson RW, Lal BK, Chakhtoura E, Goldstein J, Haser PB, Kubicka R, et al. Carotid artery stenting: analysis of data for 105 patients at high risk. J Vasc Surg. 2003;37:1234–1239
  3. Hobson RW, Lal BK, Chakhtoura EY, Goldstein J, Kubicka R, Haser PB, et al. Carotid artery closure for endarterectomy does not influence results of angioplasty-stenting for restenosis. J Vasc Surg. 2002;35:435–438
  4. Lal BK, Hobson RW, Goldstein J, Chakhtoura EY, Duran WN. Carotid artery stenting: is there a need to revise ultrasound velocity criteria?. J Vasc Surg. 2004;39:58–66
  5. Lal BK, Hobson RW, Goldstein J, Geohagan M, Chakhtoura E, Pappas PJ, et al. In-stent recurrent stenosis after carotid artery stenting: life table analysis and clinical relevance. J Vasc Surg. 2003;38:1162–1168discussion 1169
  6. Ohki T, Veith FJ. Carotid artery stenting: utility of cerebral protection devices. J Invasive Cardiol. 2001;13:47–55
  7. Roubin GS, New G, Iyer SS, Vitek JJ, Al-Mubarak N, Liu MW, et al. Immediate and late clinical outcomes of carotid artery stenting in patients with symptomatic and asymptomatic carotid artery stenosis: a 5-year prospective analysis. Circulation. 2001;103:532–537
  8. Vitek JJ, Roubin GS, New G, Al-Mubarek N, Iyer SS. Carotid angioplasty with stenting in post-carotid endarterectomy restenosis. J Invasive Cardiol. 2001;13:123–125discussion 158-70
  9. Yadav JS, Wholey MH, Kuntz RE, Fayad P, Katzen BT, Mishkel GJ, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients. N Engl J Med. 2004;351:1493–1501
  10. NACPTAR-Investigators. Update of the immediate angiographic results and in-hospitalcentral nervous system complications of cerebral percutaneous transluminal angioplasty. Circulation. 1995;92:383
  11. FDA. Circulatory system devices panel. Panel transcript. http://www.fda.gov/ohrms/dockets/ac/04/transcripts/4033t1.htm 2004.
  12. Willfort-Ehringer A, Ahmadi R, Gruber D, Gschwandtner ME, Haumer A, Haumer M, et al. Arterial remodeling and hemodynamics in carotid stents: a prospective duplex ultrasound study over 2 years. J Vasc Surg. 2004;39:728–734
  13. Piamsomboon C, Roubin GS, Liu MW, Iyer SS, Mathur A, Dean LS, et al. Relationship between oversizing of self-expanding stents and late loss index in carotid stenting. Cathet Cardiovasc Diagn. 1998;45:139–143
  14. Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, et al. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 1999;100:1872–1878
  15. ICAVL. The intersocietal commission for the accreditation of vascular laboratories: standards for accreditation in noninvasive vascular testing. Columbia, MD: ICAVL; 2005;
  16. Hobson RW, Strandness DE. Carotid artery stenosis: what’s in the measurement?. J Vasc Surg. 1993;18:1069–1070
  17. North american symptomatic carotid endarterectomy trial collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–453
  18. Abizaid A, Kornowski R, Mintz GS, Hong MK, Abizaid AS, Mehran R, et al. The influence of diabetes mellitus on acute and late clinical outcomes following coronary stent implantation. J Am Coll Cardiol. 1998;32:584–589
  19. Willfort-Ehringer A, Ahmadi R, Gessl A, Gschwandtner ME, Haumer A, Lang W, et al. Neointimal proliferation within carotid stents is more pronounced in diabetic patients with initial poor glycaemic state. Diabetologia. 2004;47:400–406
  20. Setacci C, de Donato G, Setacci F, Pieraccini M, Cappelli A, Trovato RA, et al. In-stent restenosis after carotid angioplasty and stenting: a challenge for the vascular surgeon. Eur J Vasc Endovasc Surg. 2005;29:601–607
  21. Clowes AW, Schwartz SM. Significance of quiescent smooth muscle migration in the injured rat carotid artery. Circ Res. 1985;56:139–145
  22. Garcia LA, Hosley SE, Baim DS, Carrozza JP. In vivo assessment of stent recoil in normal porcine arteries: evaluation of contemporary stent designs. Catheter Cardiovasc Interv. 2001;53:277–280
  23. Bhargava B, Karthikeyan G, Tripuraneni P. Intravascular brachytherapy: indications and management of adverse events. Am J Cardiovasc Drugs. 2004;4:385–394
  24. Kastrati A, Mehilli J, von Beckerath N, Dibra A, Hausleiter J, Pache J, et al. Sirolimus-eluting stent or paclitaxel-eluting stent vs balloon angioplasty for prevention of recurrences in patients with coronary in-stent restenosis: a randomized controlled trial. Jama. 2005;293:165–171
  25. Brito FS, Rosa WC, Arruda JA, Tedesco H, Pestana JO, Lima VC. Efficacy and safety of oral sirolimus to inhibit in-stent intimal hyperplasia. Catheter Cardiovasc Interv. 2005;64:413–418
  26. Executive committee for the asymptomatic carotid atherosclerosis study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  27. Lal BK, Hobson RW, Pappas PJ, Kubicka R, Hameed M, Chakhtoura EY, et al. Pixel distribution analysis of b-mode ultrasound scan images predicts histologic features of atherosclerotic carotid plaques. J Vasc Surg. 2002;35:1210–1217

 Competition of interest: none.Supported by grants from the American Heart Association (RA5883, BKL) and the National Institutes of Health (NS38384, RWH).

PII: S0741-5214(07)01182-2

doi: 10.1016/j.jvs.2007.07.022

Journal of Vascular Surgery
Volume 46, Issue 5 , Pages 833-840 , November 2007

Article Tools

* Image Usage & Resolution