Carotid Stenting for Post-Endarterectomy Restenosis and Radiation-Induced Occlusive Disease

Surgical treatment of carotid restenosis and radiation-induced occlusive disease is challenging because of the high morbidity and mortality associated with this procedure. Carotid stenting has been proposed as an alternative approach. We report a series of 8 patients who were treated via the percutaneous approach for either carotid restenosis (n = 4) or radiation-induced occlusive disease (n = 4). Technical success was achieved in all of the cases. There have been no deaths or strokes during the periprocedural or follow-up period. After dilation of the extracranial vessel, 1 patient experienced severe intracranial internal carotid arterial spasm that required stent placement. Wallstents® were used in 6 patients and S.M.A.R.T.™ stents were used in the remaining 2. Restenosis occurred in 2 patients and was treated successfully with redilation or restenting. Carotid stenting appears to be a feasible and safe alternative to surgery for restenosis after carotid endarterectomy and for radiation-induced occlusive disease.