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April 1982

Noninvasive Detection of Carotid Stenosis

Arch Surg. 1982;117(4):515. doi:10.1001/archsurg.1982.01380280093021

To the Editor.—Dr Cantelmo and her colleagues recently discussed the problem of recurrent carotid stenosis after endarterectomy (Archives 1981;106:1005-1008). They had a 12% rate of recurrence of stenosis, as measured by noninvasive testing. This figure is somewhat high when compared with the 1.5% rate reported by Drs Stoney and String.1 Until intraoperative arteriography is used routinely at the time of carotid endarterectomy, the true instance of recurrent stenosis will be in doubt. Some early restenotic lesions may be secondary to incomplete endarterectomy.

In my experience over the past five years, 127 carotid endarterectomies have been followed up by intraoperative arteriography. Stenosis has not recurred in this small group of patients. In approximately 8% of these patients, however, correction of a defect noted at arteriography was required. There have been no complications from the intraoperative arteriogram and the surgical procedure has not been prolonged as a result of the