Although there are several reports suggesting the safety of performing carotid endarterectomy (CE) within 4 weeks (early) of a nondisabling stroke, at many institutions it is not standard practice. Benefits of early surgery may include reduction in the number of strokes or carotid occlusions during the time between stroke and surgery, as well as a reduction in the cost of medical care due to the elimination of interval anticoagulation and close follow-up. This review examines the outcomes of early CE in selected patients after a nondisabling stroke. A total of 1065 CEs were performed between November 1991 and April 1998. Seventy-five patients were identified by computerized hospital record and office chart review as having CE after a nondisabling stroke. Criteria for early surgery included 1) nondisabling stroke ipsilateral to a carotid stenosis >50%, 2) neurological stability, and 3) no evidence of hemorrhagic stroke or significant cerebral edema by CT/MRI evaluation. This review suggests that early CE can be performed in selected patients with an acceptable perioperative morbidity and mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s100169900283 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Cerebral Embolic Protection in Patients Undergoing Left Atrial Appendage Closure.
J Cardiovasc Dev Dis
December 2024
German Heart Centre Munich, 80636 Munich, Germany.
(1) Background: Cerebral magnetic resonance imaging has reported new cerebral ischemic lesions after left atrial appendage (LAA) closure in about one- third of patients. Stroke occurs predominantly periprocedurally. This study evaluated the characteristics of embolized debris captured by the SENTINEL cerebral embolic protection system in patients undergoing LAA closure; (2) Methods: Sixty filters of 30 consecutive patients undergoing LAA closure with the WATCHMAN FLX device were collected and captured debris was analyzed by histopathology and histomorphometry.
View Article and Find Full Text PDFEndovascular Treatment in Symptomatic Intracranial Artery Stenosis: Experience from Two Centers.
Sisli Etfal Hastan Tip Bul
December 2024
Department of Radiology, Harran University Faculty of Medicine, Sanliurfa, Türkiye.
Objectives: To assess the efficacy of endovascular treatment and clinical outcomes in individuals with symptomatic intracranial stenosis who had not responded adequately to medical intervention.
Methods: The study included 32 patients who received endovascular treatment due to high-grade (70%-99% severity) intracranial atherosclerotic stenosis from December 2021 to December 2023. The patients had not experienced any acute ischemic or hemorrhagic infarction within the last three weeks, had a Modified Rankin Scale score of ≤3 at baseline, and developed a transient ischemic attack or non-disabling stroke despite having received the best medical treatment.
Comparison of the safety and efficacy of dual antiplatelet therapy versus tenecteplase in patients with minor nondisabling acute ischemic stroke.
Sci Rep
January 2025
Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
To evaluate the safety and efficacy of dual antiplatelet therapy (DAPT) versus tenecteplase in minor non-disabling acute ischemic stroke. This retrospective observational study utilized data from our stroke database. All consecutive patients with minor non-disabling acute ischemic stroke treated with either DAPT or tenecteplase between January 2020 and June 2023 were included in the analysis.
View Article and Find Full Text PDFDual antiplatelet therapy with ticagrelor vs clopidogrel in patients with TIA or minor stroke with or without symptomatic carotid artery stenosis: a post hoc analysis of the CHANCE-2 trial.
Stroke Vasc Neurol
January 2025
China National Clinical Research Center for Neurological Diseases, Beijing, China
Background And Purpose: Symptomatic internal carotid artery stenosis (sCAS) is an essential cause of transient ischaemic attack (TIA) or minor stroke. We aimed to evaluate whether the superiority of aspirin-ticagrelor over aspirin-clopidogrel varies between patients with sCAS or not.
Methods: This was a post-hoc analysis of the High-Risk Patients with Acute Nondisabling Cerebrovascular Events-II (CHANCE-2) trial, all of which were loss-of-function alleles carriers.
Determining the Optimal Age for Extracranial-Intracranial Bypass Surgery: A Post Hoc Analysis of the CMOSS Randomized Trial.
Stroke
February 2025
Department of Neurosurgery and Interventional Neuroradiology (L.J.), Xuanwu Hospital, China International Neuroscience Institute, Capital Medical University, National Center for Neurological Disorders, Beijing, China.
Background: Previous trials have failed to demonstrate the benefits of extracranial-intracranial (EC-IC) bypass surgery for patients with carotid or middle cerebral artery occlusion. However, little evidence has focused on the effect of age on prognosis. This study aimed to explore whether EC-IC bypass surgery can provide greater benefits than medical therapy alone in specific age groups.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!