Carotid Endarterectomy vs. Repeated Carotid Angioplasty and Stenting for In-Stent Restenosis

This randomized trial compares two treatments for in-stent restenosis of the carotid artery — a narrowing that develops inside a previously placed carotid stent and can increase stroke risk — in patients who require a carotid intervention: repeated balloon angioplasty with or without a new stent (endovascular approach) versus carotid endarterectomy with stent removal (open surgical approach). Both approaches are established techniques, but no randomized data directly compare their safety and effectiveness for this specific situation. Adults aged 18–80 with 70–99% in-stent restenosis in the carotid artery who are functionally independent (modified Rankin score 0–2) and have an indication for intervention are eligible; those with contraindications to anesthesia, angiography, or technically unfeasible procedures are excluded. Participants undergo neurological evaluations before the procedure and at 24 hours and 30 days afterward. This summary was prepared as patient-facing educational content using AI assistance.