RISK-FACTORS ASSOCIATED WITH RECURRENT CAROTID STENOSIS

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.