Internal Carotid Artery Stenting in a Patient with Symptomatic Restenosis After Carotid Endarterectomy

Endovascular and surgical techniques are commonly used to treat carotid artery stenoses and decrease the risk of stroke. Current guidelines regarding the timing, approach, and patient eligibility criteria for surgical and endovascular interventions are controversial. Nonetheless, these procedures broadly have low overall morbidity and mortality rates, particularly in asymptomatic patients. Carotid restenosis following carotid endarterectomy (CEA) or carotid artery stenting (CAS) is a well-recognized condition that can cause short- and long-term complications and place these patients at risk of recurrent stroke and neurological morbidity. Because of the presence of scar tissue in the surgical field, repeated CEA is often challenging; hence, CAS has emerged as a viable alternative for post-CEA restenosis. This chapter describes a patient with early restenosis after a carotid endarterectomy that was effectively treated with CAS. Recurrent stenosis after CEA is a well-known condition with an incidence of 5–22%. Treating high-grade postoperative carotid artery stenoses is mandatory to avoid ischemic stroke in the dependent supply territory. CAS is a safe and efficacious option to achieve this goal.