Restenosis after carotid endarterectomy in a multicenter regional registry.

摘要

BACKGROUND: Level I evidence shows conventional carotid endarterectomy (CEA) with patch angioplasty results in lower rates of restenosis. However, whether this information has affected practice patterns and outcomes in real-world vascular surgery settings is unclear. METHODS: Within the Vascular Study Group of New England (VSGNE), we studied 2981 patients undergoing 2981 first-time CEAs between January 1, 2003, and June 31, 2008. Rates of restenosis (defined by duplex ultrasound imaging at the 1-year follow-up) were estimated using life-table analysis. Cox proportional hazards models were used to identify multivariable predictors of postoperative restenosis 80% (HR, 4.1; 95% CI, 1.4-11.5), and dialysis dependence (HR, 3.5; 95% CI, 1.2-9.8) were independently associated with a higher risk of an 80% to 100% restenosis. Of the 51 patients with 80% to 99% restenosis, 14 underwent reintervention