FACTORS LEADING TO EARLY RECURRENCE OF CAROTID PLAQUE AFTER CAROTID ENDARTERECTOMY

BACKGROUND Carotid endarterectomy to remove atherosclerotic plaque restores blood flow and reduces the risk of cerebral ischemia. In some patients, however, postoperative plaque recurrence reduces the clinical benefit of carotid endarterectomy. METHODS Using duplex ultrasound scanning, we evaluated carotid artery restenosis in 63 endarterectomy patients followed for an average of 26.6 months after surgery. RESULTS During follow-up, two-thirds of the patients showed some observable vessel wall thickening. A negative correlation was found between years since smoking cessation and recurrence of carotid plaque. Maximum benefit was seen when smoking cessation occurred at least 1 year before endarterectomy. The least benefit was seen when smoking continued or when cessation occurred within 1 year of endarterectomy. CONCLUSIONS Smoking status was the only cardiovascular risk factor independently and significantly associated with recurrent plaque thickness.