Preventive Effects of an EPA Preparation on Restenosis after Carotid Artery Stenting

Abstract

Objective: The purpose of this study was to investigate the preventive effects of an eicosapentaenoic acid (EPA) medication on restenosis after carotid artery stenting (CAS). Methods: Of 134 patients (144 episodes) who underwent CAS in our hospital or affiliated institutions between November 2005 and September 2017, the subjects were 123 who could be followed-up for ≥30 days after procedure by carotid ultrasonography with a mean age of 73.3 years (range: 55–90 years). Males accounted for 106 (86.2%) of the patients, 61 lesions (49.6%) were symptomatic. We retrospectively compared the incidence of restenosis between the two groups: EPA-treated group (n = 43) and non-EPA-treated group (n = 80). In addition, the serum levels of fatty acid compositions had been analyzed in 97 of the 123 patients, and the relationship of the EPA/arachidonic acid (AA) ratio with perioperative ischemic complications or restenosis was examined. Results: There was no restenosis in any of the 43 EPA-treated patients, whereas it occurred in 8 (10%) of the 80 patients in the non-EPA-treated group, and the incidence of restenosis in EPA-treated group was significantly lower (p = 0.043) than that of non-EPA-treated group. In addition, the incidences of restenosis and perioperative ischemic complications were slightly higher in patients with a low EPA/AA ratio. Conclusion: Although restenosis was more frequent in patients with a low EPA/AA ratio, the administration of an EPA medication may prevent restenosis in all patients who underwent CAS.