Homocysteine as a risk factor of restenosis after carotid endarterectomy.

AIM: Homocysteine (Hcy) has been identified as a potential risk factor for vascular disease. This study investigates the role of serum Hcy as clinical risk factor for restenosis after carotid endarterectomy (CEA). METHODS: In a prospective design, we studied patients who underwent carotid endarterectomy with venous patch closure technique with respect to alterations of Hcy levels pre and postoperatively. The patients studied were subjected to reevaluation for possible restenosis at time-points 3, 6, 9, 12, 18 and 24 months postoperatively. RESULTS: Fifty-three symptomatic and 37 asymptomatic patients with stenosis of internal carotid artery >70% were studied. Restenosis appeared in 7.25% of the patients within 24 months postoperatively. Hcy was the only parameter that correlated significantly with the presence of restenosis (P=0.010) and the presence of type VI (complicated) atheromatous plaque (P=0.005) within 24 months postoperatively. CONCLUSION: Hcy levels were found to be statistically significantly correlated with both the presence of complicated atheromatous plaque and the degree of internal carotid artery restenosis after CEA.