0%, p = 0.02), the incidence of a high-grade restenosis ≥70% showed no significant find more difference between the two groups (3.3% vs. 2.8%). A clinical impact of an ISR on ipsilateral stroke or death during follow-up could not be observed. Advanced age was a clinical risk factor, which could be identified to be predictive for developing carotid restenosis [17]. To date, to the best of our knowledge, no data about rates of restenosis have yet been published by the other commonly known large randomized controlled studies

comparing CEA and CAS especially the International Carotid Stenting Study (ICSS) [31], the Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) [4], and the Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy study (SAPPHIRE) [11] and [32]. Within the analysed non-randomised trials, there was a wide range concerning the amount of treated patients. The smallest study included 100 patients [33]; the largest number of CAS patients was enrolled in the study of Setacci et al. (n = 814) [25]. In the vast majority, patients aged 60 years or over with roughly two-thirds male sex were included in the reviewed studies. The relevant data which were extracted are delineated in Table 1. The diagnostic tool used to detect an ISR was serial duplex ultrasound in all studies (n = 13).

A confirmatory diagnostic procedure such BIBW2992 nmr as CTA or conventional angiography had been carried out after ultrasound in ten studies [19], [21], [22], [23], [24], [25], [26], [27], [29] and [30]. Notably, there was a wide variation concerning the ultrasound criteria applied for the detection of an ISR between the studies. As one of the main key features for the detection of a restenosis, a cut-off peak systolic

velocity is mentioned [19], [22], [24], [26], [28], [29] and [30] sometimes in addition to other criteria such as end-diastolic velocity or the ICA/CCA index [18], [20], [21], [23], [25] and [27]. Although the minority of the studies reported concise details about the exact time point of ISR occurrence, most ISR were found Ergoloid to occur within the first year (median: 8 months, IQR: 7–9) after CAS [16], [18], [20], [21], [26], [29] and [30]. There was a broad range concerning the clinical complications for patients with ISR between 0% [21], [22], [24], [26] and [29] and 25% [30] for stroke and from 0% [19], [21], [22], [23], [25], [26] and [29] to 11.1% [18] for death, respectively. Common baseline characteristics like advanced age [19], female gender [19], prior revascularization treatment, [23], [25], [27], [34] and [35] the treatment of a radiogenic stenosis [23] or prior neck cancer [21] could be found to be predictive for ISR development. Furthermore, some cardiovascular risk factors such as smoking [17], lowered HDL cholesterol, [26] diabetes mellitus [22] or elevated HbA1c [18] and [36] could be identified as predictors for ISR, too.