The different scenarios of urgent carotid revascularization for crescendo and single transient ischemic attack
| Autor: | Andrea Stella, Emilio Pisano, Alessandro Pilato, Gianluca Faggioli, Rodolfo Pini, Mauro Gargiulo, Enrico Gallitto, Andrea Vacirca, Laura Maria Cacioppa |
|---|---|
| Přispěvatelé: | Pini, Rodolfo, Faggioli, Gianluca, Gargiulo, Mauro, Gallitto, Enrico, Cacioppa, Laura M, Vacirca, Andrea, Pisano, Emilio, Pilato, Alessandro, Stella, Andrea |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Radiology Nuclear Medicine and Imaging Time Factors medicine.medical_treatment Crescendo transient-ischemic-attack 030204 cardiovascular system & hematology Risk Assessment Stroke risk 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Medicine Humans Carotid Stenosis Endarterectomy Aged Carotid revascularization Aged 80 and over Endarterectomy Carotid endarterectomy business.industry General Medicine medicine.disease Stroke carotid stenosi Stenosis Treatment Outcome Italy Ischemic Attack Transient Cardiology Female Surgery business Cardiology and Cardiovascular Medicine 030217 neurology & neurosurgery |
| Popis: | Objective Carotid stenosis with crescendo-transient-ischemic-attack (cTIA) requires a prompt intervention to reduce the stroke risk. Few data are reported in literature about cTIA suggesting a different perioperative risk compared with patients with single TIA (sTIA). This study aimed to compare the outcome of carotid endarterectomy (CEA) in patients with TIA (single/crescendo) and evaluate the outcome risk-factors. Methods Data from two tertiary hospitals for vascular treatment were analyzed from 2007 to 2016. All patients with TIA subjected to CEA were considered, comparing the 30-day postoperative stroke and stroke/death in patients with cTIA and sTIA, particularly in the urgent (≤48 h) setting. Results On a total of 3866 CEA, 888 (23%) were performed in symptomatic patients and 515 for TIA: 365 (71%) patients with sTIA and 150 (29%) with cTIA. When compared with sTIA, cTIA patients were younger and less frequently affected by coronary disease, dyslipidemia, and chronic pulmonary disease; however, contralateral carotid occlusion was more common (20% vs. 10%, P = .004; 56% vs. 46, P = .03; 16% vs. 7%, P = .01; >80 years 26% vs. 16%, P = .01 and 2% vs. 10%, P = .001; respectively). Postoperative stroke and stroke/death were significantly higher in cTIA compared with sTIA (5.3% vs. 1.6%, P = .02 and 6.0% vs. 2.2%, P = .03; respectively). Urgent CEA was performed in 58% ( n: 87) cTIA and in 11% ( n: 56) sTIA( PConclusions cTIA subjected to CEA have a higher stroke and stroke/death risk compared with patients with sTIA. The urgent setting seems to reduce the stroke/death rate cTIA; for sTIA with a stable neurological condition, the timing of CEA did not influence the outcome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|