| Autor: |
S. Welsh, G. Mead, H. Chant, A. Picton, P.A. ONeill, C.N. McCollum |
| Předmět: |
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| Zdroj: |
Cerebrovascular Diseases; 2004, Vol. 18 Issue 3, p200-205, 6p |
| Abstrakt: |
Background: Standard practice has been to delay carotid endarterectomy (CEA) for 2 months following acute stroke to avoid a perceived risk of cerebral haemorrhage. We investigated whether early CEA reduces early recurrent stroke and improves outcome in partial anterior circulation infarction (PACI). Methods: Patients with PACI and a Barthel score of >18 before stroke underwent carotid duplex and CT imaging within 7 days of stroke. Forty consenting patients fit for surgery with greater than 70% ipsilateral carotid stenosis were randomised, 19 to early (within 24 h) and 21 to delayed surgery (at 8 weeks). Modified Rankin and Barthel scores were recorded at 1 week, 2 months, 6 and 12 months. Results: Rankin scores improved more rapidly following early surgery to a score of 1 (04) at 2 and 6 months compared with 2.5 and 2 (14), respectively, for delayed surgery (p < 0.05). Barthel scores were also significantly improved following early CEA at 7 days but both groups reached a median score of 20 by 2 months. Four delayed and 3 early patients suffered extension or recurrence of neurological deficits with 1 death in each group. Conclusions: Early CEA within 7 days of ischaemic stroke improved functional outcome with earlier hospital discharge. A large multicentre study is needed to exclude the possibility that early CEA increases the risk of cerebral haemorrhage or death.Copyright © 2004 S. Karger AG, Basel [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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