Key result
Early post-stroke carotid endarterectomy matches late surgery with 0% mortality and neurological deterioration.
Why the study?
Does early carotid endarterectomy reduce mortality or neurological deterioration compared to late carotid endarterectomy in patients with stroke and high-grade carotid stenosis?
Cohort (n=45)
Does early carotid endarterectomy reduce mortality or neurological deterioration compared to late carotid endarterectomy in patients with stroke and high-grade carotid stenosis?
Absolute Event Rate: 0% vs 0%
Early carotid endarterectomy (less than 6 weeks after stroke) appears safe, with no increased risk of mortality or neurological deterioration compared to delayed surgery.
Supports safety of early CEA after stroke in this cohort; hypothesis-generating and should not yet change practice without randomized confirmation.
The authors sought to determine if patients with stroke and a high-grade carotid stenosis benefited from a delay before carotid endarterectomy. A retrospective study of 45 patients undergoing carotid endarterectomy after stroke is presented. The patients were divided into two groups: group I (early group, n = 20), composed of patients who had carotid endarterectomy less than 6 weeks after stroke, and group II (late group, n = 25), comprised of patients who had carotid endarterectomy more than 6 weeks after stroke. As assessed by cerebral angiography, 100% of patients in group I and 64% of patients in group II had carotid artery stenoses > 76% ( P < 0.001). The median interval from stroke to carotid endarterectomy was 14 days in group I and 129 days in group II. There was no mortality in either group. No patients in either group demonstrated any neurological deterioration. The authors conclude that, in select patients, carotid endarterectomy may be done safely less than 6 weeks after stroke in order to avoid new events or carotid occlusion while awaiting surgery.
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Parrino et al. (2000) conducted a cohort in Stroke and high-grade carotid stenosis (n=45). Early carotid endarterectomy (< 6 weeks after stroke) vs. Late carotid endarterectomy (> 6 weeks after stroke) was evaluated on Mortality and neurological deterioration. Early carotid endarterectomy (<6 weeks) after stroke was performed safely with 0% mortality and 0% neurological deterioration, identical to late endarterectomy (>6 weeks).
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