Carotid Bypass Using Gore Hybrid Vascular Graft for In-stent Restenosis after Carotid Stenting

In-stent restenosis (ISR) is the most common long-term complication following carotid artery stenting (CAS), affecting 3.5% to 21% of patients after a mean follow-up of 18 months in published reports. Until now, the optimal management for ISR after CAS is still not clear, and different endovascular treatments along with various surgical options have been proposed. Moreover, surgical treatment for ISR in a previously operated patient of ipsilateral endarterectomy is a technically demanding procedure. In this report, we describe a case of severe carotid recurrent ISR, which occurred after CAS for postendarterectomy restenosis, that was successfully treated, in a straightforward way, with a carotid bypass using a Gore® Hybrid Vascular Graft.