Endarterectomy within Seven Days after the Neurological Index Event is Safe and Effective in Stroke Prevention

Carotid and Cerebrovascular Disease


Carotid Endarterectomy within Seven Days after the Neurological Index Event is Safe and Effective in Stroke Prevention


Rantner B, Kollerits B, Schmidauer C, et al (Innsbruck Med Univ, Austria) Eur J Vasc Endovasc Surg 42:732–739, 2011§



N. Singh, MD



Evidence Ranking


• B



Expert Rating


• 2



Abstract



Background


Timing of surgery remains a controversial subject with some concerns persisting that the benefit of early carotid endarterectomy (CEA) offsets the perioperative risks. We investigated the neurological outcome of patients with symptomatic internal carotid artery (ICA) stenosis after surgery in relation to the timing of treatment.



Methods


From January 2005 to June 2010, 468 patients (n = 349 male, 74.6%, median age 71 years) underwent CEA for symptomatic stenosis. Perioperative morbidity and mortality rates were assessed in the 30 days’ follow-up.



Results


The median time interval between index event and CEA was 7 days; the overall stroke and death rate reached 3.4%. There was no difference in the 30 days’ rate of stroke /death rate, depending on the timing of surgery (n = 5/241, 2.1% in patients treated within 1 week vs. n = 10/215, 4.7% in patients treated thereafter, p = 0.12). Patients with a postoperative neurological deterioration had more often an ischaemic infarction on preoperative cerebral computed tomography (CCT) compared with those without deterioration (n = 6/15, 40.0% vs. n = 39/441, 9.0%, p = 0.003). Logistic regression analysis showed that patients with preoperative infarction on CCT had the highest risk for postoperative neurological deterioration.

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Apr 1, 2017 | Posted by in CARDIOLOGY | Comments Off on Endarterectomy within Seven Days after the Neurological Index Event is Safe and Effective in Stroke Prevention

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