Long-term results of carotid endarterectomy performed in the acute period of ischemic stroke

Abstract

© 2019, Media Sfera. All rights reserved. Objective — to determine the optimal time for carotid endarterectomy (CEА) in acute period of ischemic stroke in patients with symptomatic stenosis of common carotid artery bifurcation and/or internal carotid artery over 50% through an analysis of long-term results of CEA. Material and methods. There were 108 procedures on extracranial arteries in patients with recent ischemic stroke for the period from January 2015 till June 2018 in the Department of Vascular Surgery of the Kazan City Clinical Hospital №7. The study included 94 patients. Median age was 63.8±2.9 years. Patients were divided into 2 groups depending on time of CEА. The first group (n=50) — patients undergoing early CEА (1—14 days after stroke), the second group (n=44) — patients undergoing CEA later (15—21 days). Rehabilitation, incidence of recurrent ischemic stroke and mortality were assessed within 3 and 6 months. Results. Complete recovery of neurological deficit was more common in patients undergoing early CEА (60%) compared with delayed surgery (38.6%). Absence of neurological dynamics was more common in patients of the second group (29.5%) compared with patients who were operated within 14 days after stroke (10%). Conclusion. More significant recovery of neurological deficit was observed after early CEА (1—14 days). Early and delayed CEA is not accompanied by advanced risk of perioperative complications. However, delayed CEA is characterized by reduced potential for recovery of neurological deficit.