Is there a Marker to Predict Restenosis After Carotid Stenting?

BACKGROUND Carotid atherosclerosis is the leading cause of ischemic stroke. Carotid Arteria Stenting (CAS) is a technique for carotid occlusive disease treatment. CAS procedures are performing in patients with carotid stenosis. METHODS We include 241 patients after stroke and 126 with high-graded asymptomatic stenosis in arteria carotis were included, eighteen of them had lesion type I and twenty one with lesion type IV (after stenting). Their results were compared to 91 age matched healthy controls. Included patients and controls were diagnosed by history of diseases, clinically examination, with ultrasound and MRI investigation. Included groups were evaluated by total cholesterol, LDL-cholesterol, homocysteine, hsCRP, D Dimer. RESULTS We found a correlation between serum ADMA and homocysteine levels in patients with asymptomatic stenosis (r = 0.612), P less than 0.001. It seems to be the leading factor for the stroke. In after stroke patients an important correlations are ADMA to homocysteine (r = -0.751), ADMA to LDL-cholesterol (r = 0.719), and ADMA to hsCRP (r = 0.543), P less than 0.001. In patients with in-stent restenosis (ISR) injury and restenosis we found a correlation ADMA to total cholesterol (r = 0.509) and ADMA to RR systolic (r = -0.519), P less than 0.001. CONCLUSIONS Serum ADMA levels, homocysteine, LDL-cholesterol and hsCRP concentrations in combination are useful for early identification of highly risked asymptomatic and symptomatic patients for restenosis, as well as patients after stenting of arteria carotis. Serum ADMA might be a new marker to predict early diagnosis of restenosis after carotid stenting.