Comparison of carotid endarterectomy and repeated carotid angioplasty and stenting for in-stent restenosis(CERCAS trial):a randomised study  

作　　者：Tomáš Hrbáč Jiří Fiedler Václav Procházka Tomáš Jonszta Martin Roubec David Pakizer Daniel Václavík David Netuka Tomáš Heryán David Školoudík 

机构地区：[1]Department of Neuroscience,Faculty of Medicine,Univerzity of Ostrava,Ostrava,Czech Republic [2]Department of Neurosurgery,University Hospital Ostrava,Ostrava,Czech Republic [3]Department of Neurosurgery,ČeskéBudějovice Hospital,ČeskéBudějovice,Czech Republic [4]Department of Radiology,University Hospital Ostrava,Ostrava,Czech Republic [5]Department of Neurology,University Hospital Ostrava,Ostrava,Czech Republic [6]Center for Health Research,Faculty of Medicine,University of Ostrava,Ostrava,Czech Republic [7]Department of Neurology,Vítkovice Hospital,Ostrava,Czech Republic [8]Department of Neurosurgery,Military University Hospital Prague,Praha,Czech Republic

出　　处：《Stroke & Vascular Neurology》2023年第5期399-404,共6页卒中与血管神经病学（英文）

基　　金：the Ministry of Health of the Czech Republic(grants number NV-19-04-00270,NV-19-08-00362 and NU22-04-00389).

摘　　要：Background and aim In-stent restenosis(ISR)belongs to an infrequent but potentially serious complication after carotid angioplasty and stenting in patients with severe carotid stenosis.Some of these patients might be contraindicated to repeat percutaneous transluminal angioplasty with or without stenting(rePTA/S).The purpose of the study is to compare the safety and effectiveness of carotid endarterectomy with stent removal(CEASR)and rePTA/S in patients with carotid ISR.Methods Consecutive patients with carotid ISR(≥80%)were randomly allocated to the CEASR or rePTA/S group.The incidence of restenosis after intervention,stroke,transient ischaemic attack myocardial infarction and death 30 days and 1 year after intervention and restenosis 1 year after intervention between patients in CEASR and rePTA/S groups were statistically evaluated.Results A total of 31 patients were included in the study;14 patients(9 males;mean age 66.3±6.6 years)were allocated to CEASR and 17 patients(10 males;mean age 68.8±5.6 years)to the rePTA/S group.The implanted stent in carotid restenosis was successfully removed in all patients in the CEASR group.No clinical vascular event was recorded periproceduraly,30 days and 1 year after intervention in both groups.Only one patient in the CEASR group had asymptomatic occlusion of the intervened carotid artery within 30 days and one patient died in the rePTA/S group within 1 year after intervention.Restenosis after intervention was significantly greater in the rePTA/S group(mean 20.9%)than in the CEASR group(mean 0%,p=0.04),but all stenoses were<50%.Incidence of 1-year restenosis that was≥70%did not differ between the rePTA/S and CEASR groups(4 vs 1 patient;p=0.233).Conclusion CEASR seems to be effective and save procedures for patients with carotid ISR and might be considered as a treatment option.

关 键 词：CAROTID RESTENOSIS ANGIOPLASTY 

分 类 号：R651.12[医药卫生—外科学]