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Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study.
J Vasc Surg. 2008 Sep; 48(3):595-600.JV

Abstract

OBJECTIVE

Data from multicenter symptomatic trials have shown that benefit from carotid endarterectomy (CEA) was greatest in patients with carotid disease operated within 2 weeks of their last ischemic event. We prospectively analyzed the safety and benefit of CEA performed within 2 weeks of a stroke.

METHODS

The study involved patients with acute minor stroke admitted to two stroke units who underwent CEA within 2 weeks of their last ischemic event, once they were considered neurologically stable. Preoperative workup included scoring ischemia-related symptoms according to a modified ranking scale (mRS), carotid duplex scan, transcranial Doppler ultrasound, and head computed tomography or magnetic resonance imaging. All patients underwent neurological assessment on admission, 1 day before and 2 days after CEA, and at discharge. A complete neurological and ultrasound follow-up was performed at 1, 6, and 12 months after CEA, then yearly. All procedures were eversion CEA under deep general anesthesia, with selective shunting. Endpoints were perioperative (30-day) stroke/mortality rate or cerebral bleeding and long-term stroke recurrence or cerebral hemorrhage.

RESULTS

Between 2000 and 2005, 102 patients with a mRS </= 2 underwent CEA within a median 8 days of acute ischemic stroke. Shunting and contralateral carotid occlusion were found significantly correlated. There were no perioperative strokes or deaths, or cerebral hemorrhage. All patients were followed up for a mean 34 months (range 1-66) with no recurrent stroke or cerebral bleeding.

CONCLUSIONS

CEA can be performed within 2 weeks of carotid-related ischemic stroke with no perioperative stroke or cerebral bleeding, preventing the risk of stroke recurrence.

Authors+Show Affiliations

Department of Surgical and Gastroenterological Sciences, Vascular Surgery Section of the Geriatric Surgery Clinic, University of Padua, Padova, Italy. enzo.ballotta@unipd.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

18585887

Citation

Ballotta, Enzo, et al. "Carotid Endarterectomy Within 2 Weeks of Minor Ischemic Stroke: a Prospective Study." Journal of Vascular Surgery, vol. 48, no. 3, 2008, pp. 595-600.
Ballotta E, Meneghetti G, Da Giau G, et al. Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study. J Vasc Surg. 2008;48(3):595-600.
Ballotta, E., Meneghetti, G., Da Giau, G., Manara, R., Saladini, M., & Baracchini, C. (2008). Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study. Journal of Vascular Surgery, 48(3), 595-600. https://doi.org/10.1016/j.jvs.2008.04.044
Ballotta E, et al. Carotid Endarterectomy Within 2 Weeks of Minor Ischemic Stroke: a Prospective Study. J Vasc Surg. 2008;48(3):595-600. PubMed PMID: 18585887.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study. AU - Ballotta,Enzo, AU - Meneghetti,Giorgio, AU - Da Giau,Giuseppe, AU - Manara,Renzo, AU - Saladini,Marina, AU - Baracchini,Claudio, Y1 - 2008/06/30/ PY - 2008/03/12/received PY - 2008/04/13/revised PY - 2008/04/16/accepted PY - 2008/7/1/pubmed PY - 2008/9/16/medline PY - 2008/7/1/entrez SP - 595 EP - 600 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 48 IS - 3 N2 - OBJECTIVE: Data from multicenter symptomatic trials have shown that benefit from carotid endarterectomy (CEA) was greatest in patients with carotid disease operated within 2 weeks of their last ischemic event. We prospectively analyzed the safety and benefit of CEA performed within 2 weeks of a stroke. METHODS: The study involved patients with acute minor stroke admitted to two stroke units who underwent CEA within 2 weeks of their last ischemic event, once they were considered neurologically stable. Preoperative workup included scoring ischemia-related symptoms according to a modified ranking scale (mRS), carotid duplex scan, transcranial Doppler ultrasound, and head computed tomography or magnetic resonance imaging. All patients underwent neurological assessment on admission, 1 day before and 2 days after CEA, and at discharge. A complete neurological and ultrasound follow-up was performed at 1, 6, and 12 months after CEA, then yearly. All procedures were eversion CEA under deep general anesthesia, with selective shunting. Endpoints were perioperative (30-day) stroke/mortality rate or cerebral bleeding and long-term stroke recurrence or cerebral hemorrhage. RESULTS: Between 2000 and 2005, 102 patients with a mRS </= 2 underwent CEA within a median 8 days of acute ischemic stroke. Shunting and contralateral carotid occlusion were found significantly correlated. There were no perioperative strokes or deaths, or cerebral hemorrhage. All patients were followed up for a mean 34 months (range 1-66) with no recurrent stroke or cerebral bleeding. CONCLUSIONS: CEA can be performed within 2 weeks of carotid-related ischemic stroke with no perioperative stroke or cerebral bleeding, preventing the risk of stroke recurrence. SN - 1097-6809 UR - https://www.unboundmedicine.com/medline/citation/18585887/Carotid_endarterectomy_within_2_weeks_of_minor_ischemic_stroke:_a_prospective_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741-5214(08)00656-3 DB - PRIME DP - Unbound Medicine ER -