State of the art on restenosis after carotid artery stenting: incidence, risk factors, mechanisms, diagnosis, and treatment options

Abstract

INTRODUCTION: Carotid revascularization is a well-established technique for preventing stroke in patients with significant symptomatic or asymptomatic carotid artery stenosis. Carotid artery stenting (CAS) has become an alternative to carotid endarterectomy (CEA), especially in high-risk surgical patients. However, restenosis after CAS is a potentially severe complication that can impact the medium and long-term success of the procedure and increase the risk of cerebrovascular events. METHODS: Relevant articles on restenosis after carotid stenting were searched in the PubMed database. The selected studies were evaluated for quality and relevance, and the information was summarized to provide an overview of the causes, risk factors, diagnosis, and treatment options for restenosis after CAS due to atherosclerotic carotid artery disease. RESULTS: Restenosis after CAS can occur due to various factors, including thrombosis, intimal hyperplasia, and stent migration. Several risk factors have been identified, such as age, diabetes, hypertension, dyslipidemia, and smoking. Restenosis can be diagnosed with carotid Doppler ultrasound, contrast-enhanced computed tomography, or arteriography. Treatment options include angioplasty with or without rescue stent placement, CEA associated with stent explantation, or medical treatment. CONCLUSION: Restenosis after carotid stenting is a potentially serious complication. It is especially important to identify the risk factors for restenosis and maintain close follow-up with patients after the procedure. The treatment of restenosis should be individualized. Further studies are needed to define the best strategies for preventing and treating restenosis after carotid stenting.

Keywords

• Carotid Artery Stenting
• Recurrence
• Treatment
• Carotid Artery Stenosis
• Risk Factors