| Title |
Optimalus vidinės miego arterijos endarterektomijos laikas sergant insultu ir didelio laipsnio vidinės miego arterijos stenoze / |
| Translation of Title |
The optimal timing of carotid endarterectomy in patients with stroke and severe carotid artery stenosis. |
| Authors |
Meškauskienė, Auksė ; Barkauskas, Egidijus Vytautas ; Mackevičius, Artūras |
| DOI |
10.15388/LietChirur.2006.1.2282 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija.. Vilnius : Vilniaus universiteto leidykla. 2006, t. 4, Nr. 1, p. 47-53.. ISSN 1392-0995. eISSN 1648-9942 |
| Keywords [eng] |
stroke ; carotid endarterectomy ; time ; operative risk |
| Abstract [eng] |
Background/objective. Carotid endarterectomy is highly effective in preventing stroke in patients with recentl symptomatic severe stenosis. Some studies showed early carotid endarterectomy to carry a high risk. Therefore, many surgeons delay carotid endarterectomy for 4 to 6 weeks after stroke, but any delay leads to reduced benefit because of the risk of stroke before surgery. Recent data have suggested that the operative risk is not increased in patients operated on within 30 days of stroke; however, controversy remains regarding the timing of this intervention. The purpose of the current work was to determine the operative risk of death and stroke in patients with stroke and severe carotid stenosis in relation to the time of carotid endarterectomy. Patients and methods. A retrospective study of 243 patients undergoing carotid endarterectomy after stroke is presented. All patients had either stable or improving neurological examinations. The patients were divided into four groups: group I (n = 59) patients who had carotid endarterectomy between 2–7 days after stroke, group II (n = 61) patients who had carotid endarterectomy during the second week, group III (n = 67) patients who were operated during the third–fourth week after stroke and group IV (n = 56) patients who were operated on later than 4 weeks. Results. Of the 192 men and 51 women who underwent surgery, there were 7 strokes and 7 deaths, with the total rate of complications 5.6%. Postoperative stroke and mortality was respectively: group I – 8.5%, group II – 6.5%, group III – 1.5%, group IV – 7.2%. There was no statistically significant difference in operative risk among the groups; however, a trend toward a decreased operative risk was noticed in patients operated on during the third–fourth week after stroke. Division to early (<2 weeks) and late (>2 weeks) endarterectomy also did not reveal any significant difference in the operative risk. Conclusions: The perioperative risk of stroke and death was unrelated to the timing of carotid endarterectomy in patients with stroke and severe carotid stenosis. Carotid endarterectomy can be performed safely after 2 weeks of ischemic stroke in patients with severe carotid artery stenosis. |
| Published |
Vilnius : Vilniaus universiteto leidykla |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2006 |
| CC license |
|
