Trends of Intimal Hyperplasia After Carotid Endarterectomy and Its Risk Factor Analysis

Background In this study, we investigated the changes in carotid intimal hyperplasia and the growth rate over time after carotid endarterectomy (CEA). We also assessed and analyzed risk factors for intimal growth rate after CEA to strengthen secondary prevention and control early restenosis post-CEA. Methods We randomly selected 60 patients who underwent CEA from 2019 to 2021. The median follow-up duration was 6.4 (range, 3–32) months. Intimal thickness, intimal growth rate, vascular diameter, and blood flow velocity parameters were recorded postoperatively. Analysis of variance and logistic regression were used to analyze changes and risk factors of carotid intimal hyperplasia after CEA. Results Intimal thickness (1.44 ± 0.59 mm) gradually increased; growth rate (0.246 ± 0.165 mm/month) gradually decreased. Intimal growth rate quartiles were established as follows: 0.025–0.129, 0.129–0.204, 0.204–0.323, and 0.323–0.741 mm/month. The first and fourth quartiles differed for smoking history, plaque vulnerability, procedure (CEA with patch [pCEA]), and severe vertebral or subclavian arterial stenosis. Conclusion Intimal thickness gradually increased as the growth rate gradually decreased. The intimal growth rate was elevated in smokers, individuals with vulnerable plaque carriers, and patients exhibiting severe vertebral or subclavian arterial stenosis. The intimal growth rate was lower in patients who underwent pCEA. Plaque vulnerability constituted an independent risk factor for an elevated intimal growth rate.