Duplex imaging findings predict stenosis after carotid endarterectomy

Abstract Purpose: This study was performed to determine whether early duplex findings predicted restenosis after carotid endarterectomy. Methods: One hundred ninety-two symptomatic patients who underwent carotid endarterectomy were studied with color duplex imaging at 1 day and 1 week after surgery to identify minor residual disease (causing 50% restenosis. Results: Twenty-five stenoses >50% of the operated carotid artery (13%) were identified, four at 1 day (residual) and 21 at a median follow-up of 6 months (restenosis). On multiple logistic regression analysis, >50% restenosis was found to be associated with minor day-1 residual stenosis ( p = 0.01) and with small luminal diameter of the distal internal carotid artery ( p = 0.03) as measured 1 week after carotid endarterectomy. Life table analysis showed restenosis at 24 months to be more common for patients with below-median than patients with above-median carotid bulb external diameter (18% vs 5%, respectively; p = 0.01). Conclusions: Duplex scanning within a week of carotid endarterectomy identifies >50% residual stenosis, in addition to minor residual 25% to 50% stenosis and small carotid dimensions, which are good predictors of >50% restenosis at 6 months. (J Vasc Surg 1997;26:43-8.)