Carotid endarterectomy for in-stent restenosis: a case report and literature review

Xu,Baofeng; Liu,Rui; Jiao,Liqun; Yu,Jinlu

doi:10.3892/br.2017.933

Carotid endarterectomy for in-stent restenosis: a case report and literature review

Authors:
- Baofeng Xu
- Rui Liu
- Liqun Jiao
- Jinlu Yu
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Affiliations: Department of Neurosurgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China, Department of Endocrinology, The Third Hospital of Jilin University, Changchun, Jilin 130021, P.R. China, Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 10053, P.R. China
Published online on: June 23, 2017 https://doi.org/10.3892/br.2017.933
Pages: 128-132
Copyright: © Xu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

It is relatively difficult to treat restenosis when restenosis occurs following carotid artery stenting. Endarterectomy with simultaneous stent removal is an effective approach when restenosis occurs. The treatment method is still not well known. The present paper reports a case of restenosis after stenting that was treated with endarterectomy with a satisfactory treatment outcome. The patient, a 74-year-old male, underwent stenting 10 months before he was re-hospitalized. He seemed to recover well after stenting until one month before he was re-hospitalized, when he presented symptoms of cerebral ischemia. Imaging examination revealed that in-stent stenosis had reoccurred, with the stenosis degree ranging from 70-99%. He was given endarterectomy treatment, and intra-operative findings showed that the stent grew into a carotid artery plaque and protruded below the adventitia and that the stent lumen was not covered by carotid artery intima. The surgery completely and successfully removed the plaque and the stent, while the adventitia was completely preserved. Follow-up indicated that there was no stenosis in the carotid artery, and the prognosis was good. Relevant literature was also reviewed in this paper, and the authors suggested that carotid artery plaque and stent endarterectomy is beneficial. However, surgical treatment for in-stent stenosis remains a challenging option.

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