{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:00:10Z","timestamp":1791378010764,"version":"4.3.2"},"reference-count":15,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2009,4,2]]},"published-print":{"date-parts":[[2009,7]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>In-stent restenosis (ISR) is a potentially preventable cause of stroke in carotid artery stent (CAS) patients. Understanding the frequency and timing of ISR would be useful in developing optimal protocols for carotid stent surveillance. The time course and frequency of moderate and severe ISR in our single institution prospective registry of CAS procedures is reported here.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected prospectively from 296 consecutive elective CAS procedures. Doppler surveillance was performed at 1, 6 and 12\u2005months and annually thereafter in some cases. Moderate ISR (&gt;50%) was defined as a peak systolic velocity (PSV)\u2009&gt;\u2009200\u2005cm\/s. Severe ISR (&gt;70%) was defined as PSV\u2009&gt;\u2009200\u2005cm\/s<jats:italic>and<\/jats:italic>end diastolic velocity\u2009&gt;\u2009125\u2005cm\/s or internal carotid artery\/common carotid artery ratio &gt;4. Patients with severe ISR underwent digital subtraction angiography for confirmation and possible retreatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clinical follow-up at 1\u2005year was 98%. Clinical and ultrasound follow-up at 1\u2005month was 100%, at 6\u2005months 96% and at 1\u2005year 91%. The incidence of all ISR at 6\u2005months was 8%; 5% moderate and 3% severe. Two patients had asymptomatic occlusions at 6\u2005months (0.8%). Patients with moderate ISR at 6\u2005months did not progress to severe ISR. There were two strokes caused by stent thrombosis, one acute and one delayed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Doppler surveillance is important for detecting ISR after CAS procedures. Severe ISR (&gt;70%) should be retreated in most cases as ISR may progress to occlusion. Asymptomatic patients with moderate ISR (50\u201369%) at 6\u2005months can be safely followed conservatively. Progression of ISR after 6\u201312\u2005months is uncommon over a 2\u20133\u2005year period.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnis.2009.000349","type":"journal-article","created":{"date-parts":[[2009,8,18]],"date-time":"2009-08-18T23:01:41Z","timestamp":1250636501000},"page":"44-47","source":"Crossref","is-referenced-by-count":11,"title":["Incidence and time course of carotid in-stent restenosis in a consecutive series of 295 patients"],"prefix":"10.1136","volume":"1","author":[{"given":"D","family":"Heck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2009,7,3]]},"reference":[{"key":"2024052222303967000_1.1.44.1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.497487"},{"key":"2024052222303967000_1.1.44.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.04.004"},{"key":"2024052222303967000_1.1.44.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.09.038"},{"key":"2024052222303967000_1.1.44.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.09.031"},{"key":"2024052222303967000_1.1.44.5","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A1070"},{"key":"2024052222303967000_1.1.44.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2007.07.014"},{"key":"2024052222303967000_1.1.44.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061894"},{"key":"2024052222303967000_1.1.44.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.07.012"},{"key":"2024052222303967000_1.1.44.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2005.01.033"},{"key":"2024052222303967000_1.1.44.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.10.040"},{"key":"2024052222303967000_1.1.44.11","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3171\/jns.2005.102.1.0029","article-title":"Frequency and management of recurrent stenosis after carotid stent implantation.","volume":"102","author":"Levy","year":"2005","journal-title":"J Neurosurg"},{"key":"2024052222303967000_1.1.44.12","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/152660280200900308","article-title":"Single center experience with carotid stent restenosis.","volume":"9","author":"Willfort-Ehringer","year":"2002","journal-title":"Endovasc Ther"},{"key":"2024052222303967000_1.1.44.13","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1227\/01.NEU.0000327886.32379.D0","article-title":"Low incidence of symptomatic stroke after carotid artery stenting without embolic protection devices for extracranial carotid stenosis.","volume":"63","author":"Pandey","year":"2008","journal-title":"Neurosurgery"},{"key":"2024052222303967000_1.1.44.14","doi-asserted-by":"publisher","DOI":"10.2310\/6670.2006.00054"},{"key":"2024052222303967000_1.1.44.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.02.049"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis.2009.000349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T06:01:26Z","timestamp":1716444086000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis.2009.000349"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,7]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2009,7,20]]},"published-print":{"date-parts":[[2009,7]]}},"alternative-id":["10.1136\/jnis.2009.000349"],"URL":"https:\/\/doi.org\/10.1136\/jnis.2009.000349","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,7]]}}}