RECURRENT CAROTID DISEASE - WILL STENTS BE AN ALTERNATIVE TO SURGERY

Purpose: To report the results of balloon angioplasty in recurrent car otid occlusive disease and evaluate the potential for stent implantati on. Methods and Results: Between April 1991 and September 1995, 15 pat ients with carotid restenosis underwent 17 endoluminal procedures in 3 common carotid and 14 internal carotid arteries. Two postdilation com plications (dissection and acute occlusion) required prompt stenting; one common carotid artery was stented for postdilation residual stenos is. One recurrent lesion was also stented 6 months after initial angio plasty. One stroke, 1 silent cerebral infarction, and 3 transient isch emic attacks occurred in the balloon angioplasty patients (33% neurolo gical complication rate). The common carotid stent patient died 3 days postoperatively due to hyperperfusion syndrome. Long-term follow-up i n two stent patients showed no restenosis at 18 and 48 months, respect ively. The 11 balloon angioplasty patients likewise have not demonstra ted restenosis. Conclusions: Balloon angioplasty alone appears too ris ky for treating recurrent carotid disease. Stents may offer a safer al ternative, particularly when implanted primarily.