Document Detail


Carotid endarterectomy within 2 weeks of minor ischemic stroke: a prospective study.
MedLine Citation:
PMID:  18585887     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Data from multicenter symptomatic trials have shown that benefit from carotid endarterectomy (CEA) was greatest in patients with carotid disease operated within 2 weeks of their last ischemic event. We prospectively analyzed the safety and benefit of CEA performed within 2 weeks of a stroke.
METHODS: The study involved patients with acute minor stroke admitted to two stroke units who underwent CEA within 2 weeks of their last ischemic event, once they were considered neurologically stable. Preoperative workup included scoring ischemia-related symptoms according to a modified ranking scale (mRS), carotid duplex scan, transcranial Doppler ultrasound, and head computed tomography or magnetic resonance imaging. All patients underwent neurological assessment on admission, 1 day before and 2 days after CEA, and at discharge. A complete neurological and ultrasound follow-up was performed at 1, 6, and 12 months after CEA, then yearly. All procedures were eversion CEA under deep general anesthesia, with selective shunting. Endpoints were perioperative (30-day) stroke/mortality rate or cerebral bleeding and long-term stroke recurrence or cerebral hemorrhage.
RESULTS: Between 2000 and 2005, 102 patients with a mRS </= 2 underwent CEA within a median 8 days of acute ischemic stroke. Shunting and contralateral carotid occlusion were found significantly correlated. There were no perioperative strokes or deaths, or cerebral hemorrhage. All patients were followed up for a mean 34 months (range 1-66) with no recurrent stroke or cerebral bleeding.
CONCLUSIONS: CEA can be performed within 2 weeks of carotid-related ischemic stroke with no perioperative stroke or cerebral bleeding, preventing the risk of stroke recurrence.
Authors:
Enzo Ballotta; Giorgio Meneghetti; Giuseppe Da Giau; Renzo Manara; Marina Saladini; Claudio Baracchini
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study     Date:  2008-06-30
Journal Detail:
Title:  Journal of vascular surgery     Volume:  48     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-27     Completed Date:  2008-09-12     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  595-600     Citation Subset:  IM    
Affiliation:
Department of Surgical and Gastroenterological Sciences, Vascular Surgery Section of the Geriatric Surgery Clinic, University of Padua, Padova, Italy. enzo.ballotta@unipd.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain Ischemia / complications,  etiology*,  pathology,  surgery
Carotid Stenosis / complications,  pathology,  surgery*
Cerebral Hemorrhage / etiology,  prevention & control
Endarterectomy, Carotid* / adverse effects
Female
Humans
Italy
Male
Middle Aged
Prospective Studies
Recurrence / prevention & control
Stroke / etiology*,  pathology,  prevention & control
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Perspect Vasc Surg Endovasc Ther. 2009 Sep;21(3):197-8   [PMID:  19617243 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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