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Restenosis More Common After Angioplasty Than Surgery

Last Updated: August 31, 2009.

Although patients treated for carotid artery stenosis with endovascular treatment are significantly more likely to have restenosis than those treated with carotid endarterectomy, stroke risk for both groups is low, according to two papers from the Carotid And Vertebral Artery Transluminal Angioplasty Study published online Aug. 29 in The Lancet.

MONDAY, Aug. 31 (HealthDay News) -- Although patients treated for carotid artery stenosis with endovascular treatment are significantly more likely to have restenosis than those treated with carotid endarterectomy, stroke risk for both groups is low, according to two papers from the Carotid And Vertebral Artery Transluminal Angioplasty Study published online Aug. 29 in The Lancet.

Jorg Ederle, M.D., of University College London, and colleagues conducted a study of 504 patients with carotid artery stenosis, of whom 251 were randomized to endovascular treatment while 253 underwent surgery. They found that, although the incidence for any non-perioperative stroke was 21.1 percent for the endovascular treatment group during eight years of follow-up versus 15.4 percent for the surgery group, the risk of ipsilateral non-perioperative stroke was low in both groups.

Leo H. Bonati, M.D., of University College London, and colleagues conducted a study of 413 patients, of whom 200 were given endovascular treatment while 213 were treated surgically, and found that the risk of restenosis was approximately three times higher in the endovascular treatment group, but that risk of ipsilateral non-perioperative stroke was low.

"More data from ongoing randomized trials that compare primary carotid stenting with endarterectomy are needed to assess whether modern stenting techniques are as effective as surgery for preventing restenosis in the long term and to determine accurately the relation between restenosis and recurrent stroke over time," Bonati and colleagues write.

Abstract - Ederle
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Abstract - Bonati
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