Post-endarteriectomy carotid artery stenosis

作者：Coscas Raphael^*; Castier Yves; Capdevila Clement; Coggia Marc; Koskas Fabien; Goeau Brissonniere Olivier

来源：Sang Thrombose Vaisseaux, 2011, 23(10): 529-538.

DOI：10.1684/stv.2011.0656

• Recurrent carotid stenosis
• endarteriectomy
• conventional surgery
• endovascular therapy

Post-endarteriectomy carotid artery stenosis
Since the early 1990's, carotid endarteriectomy (CEA) has been demonstrated to be the best option to prevent stroke in cases of symptomatic and asymptomatic significant carotid stenosis. Despite excellent early results, recurrent carotid stenosis (RCS) remains a major concern during follow-up mandating long term duplex scan surveillance. RCS are usually classified as follows: immediate RCS due to a technical issue, early RCS (< 18-24 months after CEA) secondary to myointimal hyperplasia, and late RCS (> 18-24 months after CEA) due to atherosclerosis recurrence. Although the natural history of RCS is not well known, there is a current consensus to intervene in case of symptomatic RCS > 50% and asymptomatic RCS > 80%. The optimal strategy between open surgery and endovascular therapy has not been determined due to the lack of randomized trials. Open surgery is the more durable option but it carries an increased local morbidity. This article reviews the etiologies, the diagnosis and the treatment of RCS in 2011.

• 出版日期2011-12