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Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy

This study aimed to describe the duplex ultrasound (DUS) findings associated with carotid restenosis after carotid endarterectomy (CEA) and to determine whether carotid restenosis is associated with the clinical outcomes of CEA. Between January 2007 and December 2016, a total of 660 consecutive pati...

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Autores principales: Kim, Hyangkyoung, Byun, Eunae, Jeong, Min-Jae, Hong, Hee Sun, Han, Youngjin, Kwon, Tae-Won, Cho, Yong-Pil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771870/
https://www.ncbi.nlm.nih.gov/pubmed/33373383
http://dx.doi.org/10.1371/journal.pone.0244544
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author Kim, Hyangkyoung
Byun, Eunae
Jeong, Min-Jae
Hong, Hee Sun
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
author_facet Kim, Hyangkyoung
Byun, Eunae
Jeong, Min-Jae
Hong, Hee Sun
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
author_sort Kim, Hyangkyoung
collection PubMed
description This study aimed to describe the duplex ultrasound (DUS) findings associated with carotid restenosis after carotid endarterectomy (CEA) and to determine whether carotid restenosis is associated with the clinical outcomes of CEA. Between January 2007 and December 2016, a total of 660 consecutive patients who underwent 717 CEAs were followed up at our hospital with DUS surveillance for at least 3 years after CEA. These patients were analyzed retrospectively for this study. Following CEA, restenosis was defined as the development of ≥50% stenosis, diagnosed on the basis of DUS findings of the luminal narrowing and velocity criteria. The study outcomes were defined as restenosis of the ipsilateral carotid artery after CEA and late (>30days) fatal or nonfatal stroke ipsilateral to the carotid restenosis. During the median follow-up period of 74 months, the restenosis incidence was 2.8% (20/717), and there were 2 strokes (2/20, 10%) ipsilateral to the restenosis after CEA; reintervention was performed for 11 patients with carotid restenosis (55%). Within 2 years after CEA, restenosis was identified in 9 cases (45%, 9/20), and 8 reinterventions (72.7%, 8/11) were performed. According to DUS findings, the morphologic characteristics of carotid restenosis were different from the preoperative plaque morphology. Among the 20 carotid restenosis cases, we observed the following DUS patterns: homogenous isoechoic restenosis (n = 14, 70%), homogenous hypoechoic (n = 2, 10%), isoechoic with hypoechoic surface (n = 3, 15%), and hypoechoic with isoechoic surface (n = 1, 5%). Although 9 carotid restenosis patients received prophylactic reintervention to mitigate the progression of restenosis, the 2 symptomatic restenosis patients had isoechoic lesions with hypoechoic surfaces on DUS. On Kaplan–Meier survival analyses, in terms of stroke-free survival rates, there was a higher risk of stroke among patients with carotid restenosis compared with patients without restenosis, with a non-significant trend (P = 0.051). In conclusion, most carotid restenoses were identified within 2 years after CEA, and there was a non-significant trend toward a higher risk of stroke among patients with carotid restenosis.
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spelling pubmed-77718702021-01-08 Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy Kim, Hyangkyoung Byun, Eunae Jeong, Min-Jae Hong, Hee Sun Han, Youngjin Kwon, Tae-Won Cho, Yong-Pil PLoS One Research Article This study aimed to describe the duplex ultrasound (DUS) findings associated with carotid restenosis after carotid endarterectomy (CEA) and to determine whether carotid restenosis is associated with the clinical outcomes of CEA. Between January 2007 and December 2016, a total of 660 consecutive patients who underwent 717 CEAs were followed up at our hospital with DUS surveillance for at least 3 years after CEA. These patients were analyzed retrospectively for this study. Following CEA, restenosis was defined as the development of ≥50% stenosis, diagnosed on the basis of DUS findings of the luminal narrowing and velocity criteria. The study outcomes were defined as restenosis of the ipsilateral carotid artery after CEA and late (>30days) fatal or nonfatal stroke ipsilateral to the carotid restenosis. During the median follow-up period of 74 months, the restenosis incidence was 2.8% (20/717), and there were 2 strokes (2/20, 10%) ipsilateral to the restenosis after CEA; reintervention was performed for 11 patients with carotid restenosis (55%). Within 2 years after CEA, restenosis was identified in 9 cases (45%, 9/20), and 8 reinterventions (72.7%, 8/11) were performed. According to DUS findings, the morphologic characteristics of carotid restenosis were different from the preoperative plaque morphology. Among the 20 carotid restenosis cases, we observed the following DUS patterns: homogenous isoechoic restenosis (n = 14, 70%), homogenous hypoechoic (n = 2, 10%), isoechoic with hypoechoic surface (n = 3, 15%), and hypoechoic with isoechoic surface (n = 1, 5%). Although 9 carotid restenosis patients received prophylactic reintervention to mitigate the progression of restenosis, the 2 symptomatic restenosis patients had isoechoic lesions with hypoechoic surfaces on DUS. On Kaplan–Meier survival analyses, in terms of stroke-free survival rates, there was a higher risk of stroke among patients with carotid restenosis compared with patients without restenosis, with a non-significant trend (P = 0.051). In conclusion, most carotid restenoses were identified within 2 years after CEA, and there was a non-significant trend toward a higher risk of stroke among patients with carotid restenosis. Public Library of Science 2020-12-29 /pmc/articles/PMC7771870/ /pubmed/33373383 http://dx.doi.org/10.1371/journal.pone.0244544 Text en © 2020 Kim et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kim, Hyangkyoung
Byun, Eunae
Jeong, Min-Jae
Hong, Hee Sun
Han, Youngjin
Kwon, Tae-Won
Cho, Yong-Pil
Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title_full Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title_fullStr Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title_full_unstemmed Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title_short Duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
title_sort duplex ultrasound findings and clinical outcomes of carotid restenosis after carotid endarterectomy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771870/
https://www.ncbi.nlm.nih.gov/pubmed/33373383
http://dx.doi.org/10.1371/journal.pone.0244544
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