Treatment of restenosis after percutaneous transluminal angioplasty for internal carotid artery stenosis

The efficacy of repealed percutaneous transluminal angioplasty (PTA) and ca rotid endarterectomy (CEA) was examined in patients with restenosis after P TA for carotid stenosis. After percutaneous transluminal angioplasty (PTA) for 63 cases of internal carotid stenoses 13 cases of restenosis appeared. They were treated by PTA or carotid endarterectomy. The treatment was chose n by the patient after explanation of each treatment. We initially treated seven patients by repeat PTA and six by carotid endarterectomy. The degree of stenosis improved from 82 % to 30 % on average after repeated PTA. Howev er, one patient in the PTA group had restenosis, and carotid endarterectomy was then performed. The other cases also had restenosis and were treated b y PTA. The six cases treated by carotid endarterectomy were successfully tr eated without difficulty. The success rate of PTA was 5/7 (71 %) in the res tenosis cases. Patients with a greater residual stenosis after initial PTA had significantly more frequent restenosis. Repeat PTA and CEA both appeare d effective treatment for restenosis after initial PTA, although PTA had a restenosis rate similar to that of initial PTA.