Reconstructive operations on carotid arteries as a crucial part of the comprehensive treatment of acute ischemic stroke

Here we have analyzed the results of 51 carotid reconstructions in 51 symptomatic patients with acute stroke.This group amounted to 17.3% of all the hospitalized patients with various acute cerebral circulation disturbances (ACCD). Among the operated patients, 40 (78.43%) suffered of ischemic stroke, and 11 (21.57%) showed transitory ischemic attacks. The patients were divided into three groups: group 1,24 (47.05%) patients suffering an ischemic stroke or transitory ischemic attack and operated on within 2 weeks (usually 2 to 12 days) after the beginning of disease; group II, 15 (29.41%) patients who have suffered an ischemic stroke or transitory ischemic attack and were operated on 2 to 4 weeks after the beginning of disease; group III, 12 (23.53%) patients who have suffered an ischemic stroke and were operated on later than one month after the beginning of disease. In these three groups, we have compared the results of carotid reconstructions considering the patients'age, gender, degree of stenosis, Charlson's co-morbidity index, and presence and severity of accompanying diseases. The patients of all the groups were assessed according to NIHHS score, Rivermide an modified RAnkin score before the operation and after the operation in 24 hours, 7 days and when leaving the hospital. Our analyzes reveal a low risk of reconstructive operation on carotid arteries performed within the first 14 days after an acute ischemic stroke in the carotid basin. They furthermore show that endarterectomy in the acute period results in the majority of cases in an early regress of the neurological symptoms.