Carotid artery surgery

[GH2]

My father had carotid artery surgery 1-1/2 years ago.  He lost vision and upon an ultrasound they found 90% blockage in both arteries.  Both arteries were surgically corrected with I believe  is a gortex artificial device.  He recently lost vision again and  upon ultrasound they found it to be 90% blocked again.  Why/How does this artery become blocked again after only 1-1/2 years?  They are now discussing using a vein out of his leg, even though he has lower circulatory problems and a history of a blood clot at his ankle. This is questionable.

[Cleveland Clinic, MD]

Restenosis (the recurrence of blockages) is unfortunately a common problem.  There are a variety of reasons for this including intimal hyperplasia, plaque regrowth and recoil.  A possible alternative to repeat surgery is stenting of the carotid.

[kd]

I had read that carotid stenting was controversial because it could cause increased placque build up around the stent.  This was a couple of years ago.  Is this not true anymore?  Is stenting still experimental or is it main-line endartarectomy procedure now?  What are the drawbacks?

[Cleveland Clinic, MD]

Not experimental but not quite mainstream.  The benefit is avoiding surgery the disadvantage is a higher risk or reblockage.  It's only being done at certain centers.  If he would like to be seen here to be considered for carotid artery stenting he can call the number below to make an appointment with Dr. Jay Yadav.