Table_1_Treatment of the Carotid In-stent Restenosis: A Systematic Review.DOCX
Background and Purpose: In-stent restenosis (ISR) after carotid artery stent (CAS) is not uncommon. We aimed to evaluate therapeutic options for ISR after CAS.
Methods: We searched PubMed and EMBASE until November 2, 2020 for studies including the treatment for ISR after CAS.
Results: In total, 35 studies, covering 1,374 procedures in 1,359 patients, were included in this review. Most cases (66.3%) were treated with repeat CAS (rCAS), followed by percutaneous transluminal angioplasty (PTA) (17.5%), carotid endarterectomy (CEA) (14.3%), carotid artery bypass (1.5%), and external beam radiotherapy (0.4%). The rates of stroke & TIA within the postoperative period were similar in three groups (PTA 1.1%, rCAS 1.1%, CEA 1.5%). CEA (2.5%) was associated with a slightly higher rate of postoperative death than rCAS (0.7%, P = 0.046). Furthermore, the rate of long-term stroke & TIA in PTA was 5.7%, significantly higher than rCAS (1.8%, P = 0.036). PTA (27.8%) was also associated with a significantly higher recurrent restenosis rate than rCAS (8.2%, P = 0.002) and CEA (1.6%, P < 0.001). The long-term stroke & TIA and recurrent restenosis rates showed no significant difference between rCAS and CEA.
Conclusions: rCAS is the most common treatment for ISR, with low postoperative risk and low long-term risk. CEA is an important alternative for rCAS. PTA may be less recommended due to the relatively high long-term risks of stroke & TIA and recurrent restenosis.
History
References
- https://doi.org//10.1161/01.STR.30.12.2513
- https://doi.org//10.1016/j.ejvs.2018.03.023
- https://doi.org//10.1016/S0140-6736(15)01309-4
- https://doi.org//10.1161/STROKEAHA.110.589309
- https://doi.org//10.1016/j.jacc.2017.02.053
- https://doi.org//10.1002/14651858.CD000515.pub5
- https://doi.org//10.1136/neurintsurg-2018-014534
- https://doi.org//10.1016/S1474-4422(18)30195-9
- https://doi.org//10.1016/j.jvir.2010.06.010
- https://doi.org//10.1016/j.jvs.2016.07.106
- https://doi.org//10.1016/j.jvs.2016.11.041
- https://doi.org//10.1007/s00234-017-1935-7
- https://doi.org//10.5114/aic.2019.90221
- https://doi.org//10.1016/j.jvs.2020.07.102
- https://doi.org//10.1017/cjn.2019.277
- https://doi.org//10.1136/bmj.b2700
- https://doi.org//10.1016/j.jvs.2016.05.086
- https://doi.org//10.1067/mva.2001.111880
- https://doi.org//10.1016/j.jvs.2005.10.040
- https://doi.org//10.1002/ccd.20809
- https://doi.org//10.1016/j.jvs.2011.03.106
- https://doi.org//10.1136/jnis.2009.000323
- https://doi.org//10.1583/11-3535.1
- https://doi.org//10.1583/11-3805R.1
- https://doi.org//10.1177/152660280200900308
- https://doi.org//10.1053/ejvs.2002.1916
- https://doi.org//10.1016/j.jvs.2003.08.021
- https://doi.org//10.3171/jns.2005.102.1.0029
- https://doi.org//10.1007/s00508-005-0332-0
- https://doi.org//10.1016/j.ejvs.2005.01.033
- https://doi.org//10.1583/06-1811.1
- https://doi.org//10.1016/j.avsg.2007.08.002
- https://doi.org//10.1007/s00392-010-0188-9
- https://doi.org//10.1016/j.jvs.2011.04.009
- https://doi.org//10.1055/s-0032-1311535
- https://doi.org//10.1583/JEVT-12-3942R.1
- https://doi.org//10.1583/JEVT-12-4042R.1
- https://doi.org//10.1583/14-4715MR.1
- https://doi.org//10.1016/j.jcin.2013.11.004
- https://doi.org//10.3760/cma.j.issn.0376-2491.2015.24.006
- https://doi.org//10.1177/1538574416677668
- https://doi.org//10.1136/neurintsurg-2015-011938
- https://doi.org//10.18999/nagjms.78.2.143
- https://doi.org//10.23736/S0021-9509.16.09175-X
- https://doi.org//10.1136/svn-2017-000089
- https://doi.org//10.1148/radiol.2292030516
- https://doi.org//10.1161/STROKEAHA.110.595330
- https://doi.org//10.1056/NEJMoa040127
- https://doi.org//10.1136/neurintsurg-2012-010618
- https://doi.org//10.1016/j.jvs.2008.10.016
- https://doi.org//10.1583/04-1527.1
- https://doi.org//10.1016/j.jvs.2007.09.038
- https://doi.org//10.2214/AJR.12.9114
- https://doi.org//10.1002/jmri.27341
- https://doi.org//10.3174/ajnr.A4073
- https://doi.org//10.1001/jamaneurol.2020.2658
- https://doi.org//10.1016/j.ijporl.2003.08.023
- https://doi.org//10.3174/ajnr.A3016
- https://doi.org//10.1016/j.jcin.2014.01.163
- https://doi.org//10.4244/EIJ-D-18-01191
- https://doi.org//10.1136/neurintsurg-2017-013004
- https://doi.org//10.1016/j.jvs.2010.11.118
- https://doi.org//10.1007/s12975-019-00693-z
- https://doi.org//10.1016/j.jcin.2014.09.023
CC BY 4.0