Stenosegrad im Ultraschall nach Karotisstenting

Follow-up observation after stent-protected angioplasty of a carotid artery stenosis is carried out with the aim of detecting possible restenosis of the vessel.

This article discusses the special features that need to be considered in the duplex sonographic follow-up of carotid stents.

According to current data restenosis after carotid angioplasty occurs in up to 41% of patients over the long term and is associated with a significantly higher risk of stroke recurrence. The method of choice for the detection of restenosis after carotid stenting is duplex sonography. For multifactorial reasons the peak systolic velocity (PSV) measured by duplex sonography can be increased in the stent area after carotid stenting without this representing a relevant narrowing of the vessel. The threshold value for hemodynamically relevant in-stent restenosis >50% is > 240 cm/s, which is around 20% above the criteria established in German-speaking countries for the evaluation of the carotid duplex.

The criteria established in German-speaking countries for the evaluation of the carotid duplex cannot be applied without restriction to the carotid duplex after stent angioplasty as a relevant narrowing of the vessel within the stent is only to be expected at a PSV higher than in the naïve vessel. This must be taken into account during the follow-up observation of patients with carotid stenting in order to avoid unnecessary reinterventions.