The incidence of restenosis following carotid endarterectomy reported
with duplex scanning has ranged from 6-19%. The aim of this study was
to determine the importance of risk factors in the development of caro
tid stenosis following carotid endarterectomy. Two hundred-thirty pati
ents who underwent carotid endarterectomy (nineteen bilateral carotid
endarterectomies) and had complete follow-up with duplex scanning for
at least one year have been studied between February 1983 and April 19
89. Forty six patients developed restenosis (18.5% of carotid endarter
ectomies) whereas 184 patients did not restenose. All patients were st
udied for the following risk factors: age, sex, ischemic heart disease
, smoking habit, family history of cardiovascular disease diabetes mel
litus, hyperlipidemia and peripheral vascular disease. The incidence o
f ischemic heart disease, a positive family history of cardiovascular
disease, hyperlipidemia and diabetes mellitus was significantly increa
sed (p<0.05) in patients with recurrent carotid stenosis (80.4%, 71.7%
, 58.7%, 32.6% respectively) as compared to patients without a recurre
nt stenosis (55.7%, 33.5%, 31%, 10.5%). None of the above significant
risk factors was strongly associated with early (<2 years) carotid res
tenosis. There is an increased prevalence of clinical atherosclerotic
risk factors such as family history of cardiovascular disease, diabete
s mellitus, ischemic heart disease and hyperlipidemia in patients who
develop carotid restenosis.