Document Detail


Timing of carotid endarterectomy after acute stroke.
MedLine Citation:
PMID:  2296104     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An arbitrary delay of at least 6 weeks before performing carotid endarterectomy after acute stroke has been recommended based on anecdotal reports. This prolonged interval may increase the danger of recurrent neurologic deficit before surgery. From September 1978 to September 1988, carotid endarterectomy was performed on 140 patients at variable intervals after stroke. Eleven patients had temporary stroke, which left 129 patients with neurologic symptoms that persisted for 3 weeks or had a cortical infarct on CT scanning. A prospective therapeutic protocol was applied to 82 patients admitted with acute stroke. They were observed until neurologic recovery reached a plateau, based on clinical observation by a neurologist, before performing angiography and carotid endarterectomy (group I). Forty-seven patients were not seen until after recovery from stroke was established (group II). At initial presentation, the severity of neurologic deficit was classified as mild, moderate, or severe in 31%, 58%, and 11%, respectively. Recovery before operation was registered as complete in 11%, mild residual in 66%, moderate residual in 21%, and severe residual in 2%. Group I patients (n = 82, 64%) were operated on within 6 weeks of stroke and group II (n = 47, 36%) were operated on at varying times after 6 weeks. No significant difference was found in the incidence of cerebrovascular events (1.2% vs 4.2%) and deaths (1.3% vs 2.1%) between groups I and II with respect to the timing of carotid endarterectomy, and no significant difference was found between patients operated on at 2, 4, 6, or more than 6 weeks after stroke.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J J Piotrowski; V M Bernhard; J R Rubin; K E McIntyre; J M Malone; F N Parent; G C Hunter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  11     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1990 Jan 
Date Detail:
Created Date:  1990-02-22     Completed Date:  1990-02-22     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:  45-51; discussion 51-2     Citation Subset:  IM    
Affiliation:
University of Arizona Health Sciences Center, Section of Vascular Surgery, Tucson 85724.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Carotid Arteries / surgery*
Cerebrovascular Disorders / mortality,  radiography,  surgery*
Endarterectomy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Nervous System Diseases / etiology
Postoperative Complications
Postoperative Period
Retrospective Studies
Time Factors

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


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