Safety of early endarterectomy in patients with symptomatic
carotid artery stenosis: an international multicenter study

J 2014

Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study

TSIVGOULIS, G., C. KROGIAS, G.S. GEORGIADIS, Robert MIKULÍK, A. SAFOURIS et. al.

Základní údaje

Originální název

Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study

Autoři

TSIVGOULIS, G. (300 Řecko), C. KROGIAS (276 Německo), G.S. GEORGIADIS (300 Řecko), Robert MIKULÍK (203 Česká republika, garant), A. SAFOURIS (56 Belgie), S.H. MEVES (276 Německo), K. VOUMVOURAKIS (300 Řecko), Michal HARŠÁNY (703 Slovensko, domácí), Robert STAFFA (203 Česká republika, domácí), S.G. PAPAGEORGIOU (300 Řecko), A.H. KATSANOS (300 Řecko), A. LAZARIS (300 Řecko), A. MUMME (276 Německo), M. LAZARIDES (300 Řecko) a S.N. VASDEKIS (300 Řecko)

Vydání

European Journal of Neurology, Hoboken, Wiley-Blackwell, 2014, 1351-5101

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30000 3. Medical and Health Sciences

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 4.055

Kód RIV

RIV/00216224:14110/14:00078741

Organizační jednotka

Lékařská fakulta

DOI

http://dx.doi.org/10.1111/ene.12461

UT WoS

000342985200004

Klíčová slova anglicky

carotid artery; carotid endarterectomy; early; stroke

Štítky

EL OK

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 24. 4. 2015 13:37, Ing. Mgr. Věra Pospíšilíková

Anotace

V originále

Although the latest recommendations suggest that carotid endarterectomy (CEA) should be performed in symptomatic carotid artery stenosis (sCAS) patients within 2weeks of the index event, only a minority of patients undergo surgery within the recommended time-frame. The aim of this international multicenter study was to prospectively evaluate the safety of early CEA in patients with sCAS in everyday clinical practice settings. Consecutive patients with non-disabling acute ischaemic stroke (AIS) or transient ischaemic attack (TIA) due to sCAS (70%) underwent early (14days) CEA at five tertiary-care stroke centers during a 2-year period. Primary outcome events included stroke, myocardial infarction (MI) or death occurring during the 30-day follow-up period and were defined according to the International Carotid Stenting Study criteria. A total of 165 patients with sCAS [mean age 6910years; 69% men; 70% AIS; 6% crescendo TIA; 8% with contralateral internal carotid artery (ICA) occlusion] underwent early CEA (median elapsed time from symptom onset 8days). Urgent CEA (2days) was performed in 20 cases (12%). The primary outcomes of stroke and MI were 4.8% [95% confidence interval (CI) 1.5%-8.1%] and 0.6% (95% CI 0%-1.8%). The combined outcome event of non-fatal stroke, non-fatal MI or death was 5.5% (95% CI 2.0%-9.0%). Crescendo TIA, contralateral ICA occlusion and urgent CEA were not associated (P>0.2) with a higher 30-day stroke rate. Our findings indicate that the risk of early CEA in consecutive unselected patients with non-disabling AIS or TIA due to sCAS is acceptable when the procedure is performed within 2weeks (or even within 2days) from symptom onset. Click for the corresponding questions to this CME article.

Citovat

TSIVGOULIS, G., C. KROGIAS, G.S. GEORGIADIS, Robert MIKULÍK, A. SAFOURIS, S.H. MEVES, K. VOUMVOURAKIS, Michal HARŠÁNY, Robert STAFFA, S.G. PAPAGEORGIOU, A.H. KATSANOS, A. LAZARIS, A. MUMME, M. LAZARIDES a S.N. VASDEKIS. Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study. European Journal of Neurology. Hoboken: Wiley-Blackwell, 2014, roč. 21, č. 10, s. 1251-1257, "e75"-"e76", 9 s. ISSN 1351-5101. Dostupné z: https://dx.doi.org/10.1111/ene.12461.

@article{1218839,
   author = {Tsivgoulis, G. and Krogias, C. and Georgiadis, G.S. and Mikulík, Robert and Safouris, A. and Meves, S.H. and Voumvourakis, K. and Haršány, Michal and Staffa, Robert and Papageorgiou, S.G. and Katsanos, A.H. and Lazaris, A. and Mumme, A. and Lazarides, M. and Vasdekis, S.N.},
   article_location = {Hoboken},
   article_number = {10},
   doi = {http://dx.doi.org/10.1111/ene.12461},
   keywords = {carotid artery; carotid endarterectomy; early; stroke},
   language = {eng},
   issn = {1351-5101},
   journal = {European Journal of Neurology},
   title = {Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study},
   volume = {21},
   year = {2014}
}

TY  - JOUR
ID  - 1218839
AU  - Tsivgoulis, G. - Krogias, C. - Georgiadis, G.S. - Mikulík, Robert - Safouris, A. - Meves, S.H. - Voumvourakis, K. - Haršány, Michal - Staffa, Robert - Papageorgiou, S.G. - Katsanos, A.H. - Lazaris, A. - Mumme, A. - Lazarides, M. - Vasdekis, S.N.
PY  - 2014
TI  - Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study
JF  - European Journal of Neurology
VL  - 21
IS  - 10
SP  - 1251-1257, "e75"-"e76"
EP  - 1251-1257, "e75"-"e76"
PB  - Wiley-Blackwell
SN  - 13515101
KW  - carotid artery
KW  - carotid endarterectomy
KW  - early
KW  - stroke
N2  - Although the latest recommendations suggest that carotid endarterectomy (CEA) should be performed in symptomatic carotid artery stenosis (sCAS) patients within 2weeks of the index event, only a minority of patients undergo surgery within the recommended time-frame. The aim of this international multicenter study was to prospectively evaluate the safety of early CEA in patients with sCAS in everyday clinical practice settings. Consecutive patients with non-disabling acute ischaemic stroke (AIS) or transient ischaemic attack (TIA) due to sCAS (70%) underwent early (14days) CEA at five tertiary-care stroke centers during a 2-year period. Primary outcome events included stroke, myocardial infarction (MI) or death occurring during the 30-day follow-up period and were defined according to the International Carotid Stenting Study criteria. A total of 165 patients with sCAS [mean age 6910years; 69% men; 70% AIS; 6% crescendo TIA; 8% with contralateral internal carotid artery (ICA) occlusion] underwent early CEA (median elapsed time from symptom onset 8days). Urgent CEA (2days) was performed in 20 cases (12%). The primary outcomes of stroke and MI were 4.8% [95% confidence interval (CI) 1.5%-8.1%] and 0.6% (95% CI 0%-1.8%). The combined outcome event of non-fatal stroke, non-fatal MI or death was 5.5% (95% CI 2.0%-9.0%). Crescendo TIA, contralateral ICA occlusion and urgent CEA were not associated (P>0.2) with a higher 30-day stroke rate. Our findings indicate that the risk of early CEA in consecutive unselected patients with non-disabling AIS or TIA due to sCAS is acceptable when the procedure is performed within 2weeks (or even within 2days) from symptom onset. Click for the corresponding questions to this CME article.
ER  -

TSIVGOULIS, G., C. KROGIAS, G.S. GEORGIADIS, Robert MIKULÍK, A. SAFOURIS, S.H. MEVES, K. VOUMVOURAKIS, Michal HARŠÁNY, Robert STAFFA, S.G. PAPAGEORGIOU, A.H. KATSANOS, A. LAZARIS, A. MUMME, M. LAZARIDES a S.N. VASDEKIS. Safety of early endarterectomy in patients with symptomatic carotid artery stenosis: an international multicenter study. \textit{European Journal of Neurology}. Hoboken: Wiley-Blackwell, 2014, roč.~21, č.~10, s.~1251-1257, ''e75''-''e76'', 9 s. ISSN~1351-5101. Dostupné z: https://dx.doi.org/10.1111/ene.12461.

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