Presenter of 2 Presentations
EMERGENCY CAROTID ENDARTERECTOMY AFTER TIA OR NON-DISABLING STROKE IS SAFE
EMERGENCY CAROTID ENDARTERECTOMY AFTER TIA OR NON-DISABLING STROKE IS SAFE
Abstract
Background and Aims
Stroke is associated with a 46% risk of recurrence in the first 14 days following the event. Carotid endarterectomy (CEA) is an effective form of stroke prevention and is recommended to be performed within 2 weeks following stroke. On the other hand, emergency CEA is controversial due to a high risk of complications.
Methods
We performed retrospective analysis of our prospectively collected database of patients operated for carotid stenosis between 2006 and 2020. We analyzed the occurrence of major adverse events, such as stroke, acute myocardial infarction or death after surgery. Further, minor adverse events, such as cranial nerve lesion, hematoma or hyperperfusion syndrome were analyzed. CEA performed within 48 hours after stroke was defined as emergency CEA.
Results
Since 2006 till 2020 we performed emergency CEA in 277 patients, including 196 males and 81 females. The mean age was 66 years. The surgery was performed in awake patients under local anesthesia. Stroke, myocardial infarction or death occurred in 11 (4.0%) of the 277 patients operated within 2 days after stroke. In patients operated within 24 hours after stroke, the risk of these adverse events was even lower, being 2.9% (4 out of 139). Concerning minor adverse events, hematomas were present in 16 patients (5.8%), cranial nerve paresis in 5 patients (1.8%), and vocal cord paralysis in 4 patients (1.4%). The cerebal hyperperfusion syndrome occurred in 2 patients (0.7%) operated on the day of surgery.
Conclusions
We conclude that emergency carotid endarterectomy is safe after TIA or non-disabling stroke.