Carotid Restenosis: Incidence, Pathophysiology and Therapeutic Options

TL;DR

This paper discusses carotid restenosis, a common complication after carotid treatments, and explores its causes and treatment options.

Contribution

The paper provides an updated overview of the incidence, pathophysiology, and therapeutic strategies for carotid restenosis.

Findings

The 2-year restenosis rate after carotid treatments is 6–12%.

Inflammation processes are linked to both early and late restenosis.

Treatment options include lifestyle changes, medical therapy, and personalized procedural techniques.

Abstract

Restenosis after carotid endarterectomy and carotid artery stenting remains the main complication after both surgical and endovascular treatment of carotid stenosis, with a 2-year restenosis rate of 6–12%. Complex inflammation processes are the cause of early (<2 years) and late (>2 years) restenosis and principal systemic risk factors are female gender, hypertension, diabetes, dyslipidemia, and smoking. Non-procedural treatment includes lifestyle modifications and best medical therapy. The procedural treatment, considered mostly for symptomatic patients, includes different open and endovascular techniques. The management should be personalized according to patient and plaque characteristics.

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