Re. 'Carotid endarterectomy with stent removal in management of in-stent restenosis: a safe, feasible, and effective technique'.

Introduction The optimal treatment of in-stent restenosis (ISR) is not determined. We describe the efficacy of carotid endarterectomy (CEA) with stent removal in the management of symptomatic ISR. Methods A 72-year-old man presented with recurrent right limb weakness 8 months after carotid artery stenting. Digital substraction angiography showed severe ISR (almost 99%). CEA with stent removal was performed. Results A total of 41 cases was reviewed: periarterial inflammation was shown in 10.3% of patients; 92.9% had clear intima–media plane; and 85.4% had a good outcome. All patients remained stable at follow-up. Discussion CEA with stent removal appears to be a safe, feasible, effective, and durable therapeutic option.