Carotid Endarterectomy within Seven Days after the Neurological Index Event is Safe and Effective in Stroke Prevention
| Autor: | Barbara Rantner, Michael Rieger, Gustav Fraedrich, Johann Willeit, Barbara Kollerits, M. Thauerer, C. Schmidauer |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Infarction Early treatment policy Carotid endarterectomy Postoperative Complications Risk Factors medicine.artery Secondary Prevention Medicine Humans Carotid Stenosis Survival rate Stroke Endarterectomy Aged Neurologic Examination Medicine(all) Ischaemic event Endarterectomy Carotid business.industry Mortality rate Perioperative Cerebral Infarction Middle Aged medicine.disease Surgery Survival Rate Disease Progression Female Internal carotid artery Cardiology and Cardiovascular Medicine business Carotid Artery Internal Follow-Up Studies |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 42(6):732-739 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/j.ejvs.2011.08.004 |
| Popis: | 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. Conclusion An infarction on the preoperative CCT leads to an increased risk for a postoperative deterioration after CEA. Patients should be treated at an early point in time with bland CCTs. |
| Databáze: | OpenAIRE |
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