2019
Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study
ROUSSOPOULOU, A.; G. TSIVGOULIS; C. KROGIAS; A. LAZARIS; K. MOULAKAKIS et al.Základní údaje
Originální název
Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study
Autoři
ROUSSOPOULOU, A.; G. TSIVGOULIS; C. KROGIAS; A. LAZARIS; K. MOULAKAKIS; G.S. GEORGIADIS; Robert MIKULÍK; J.D. KAKISIS; C. ZOMPOLA; S. FAISSNER; M. CHONDROGIANNI; C. LIANTINIOTI; T. HUMMEEL; A. SAFOURIS; P. MATSOT; K. VOUMVOURAKIS; M. LAZARIDES; G. GEROULAKOS a S.N. VASDEKIS
Vydání
European Journal of Neurology, Oxford, Rapid Science Ltd. 2019, 1351-5101
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30210 Clinical neurology
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 4.516
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/19:00109548
Organizační jednotka
Lékařská fakulta
UT WoS
EID Scopus
Klíčová slova anglicky
carotid; endarterectomy; safety; stroke; TIA; urgent
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 29. 4. 2019 14:35, Soňa Böhmová
Anotace
V originále
Background and purpose International recommendations advocate that carotid endarterectomy (CEA) should be performed within 2 weeks from the index event in symptomatic carotid artery stenosis (sCAS) patients. However, there are controversial data regarding the safety of CEA performed during the first 2 days of ictus. The aim of this international, multicenter study was to prospectively evaluate the safety of urgent (0-2 days) in comparison to early (3-14 days) CEA in patients with sCAS. Methods Consecutive patients with non-disabling (modified Rankin Scale scores <= 2) acute ischaemic stroke or transient ischaemic attack due to sCAS (>= 70%) underwent urgent or early CEA at five tertiary-care stroke centers during a 6-year period. The primary outcome events included stroke, myocardial infarction or death during the 30-day follow-up period. Results A total of 311 patients with sCAS underwent urgent (n = 63) or early (n = 248) CEA. The two groups did not differ in baseline characteristics with the exception of crescendo transient ischaemic attacks (21% in urgent vs. 7% in early CEA; P = 0.001). The 30-day rates of stroke did not differ (P = 0.333) between patients with urgent (7.9%; 95% confidence interval 3.1%-17.7%) and early (4.4%; 95% confidence interval 2.4%-7.9%) CEA. The mortality and myocardial infarction rates were similar between the two groups. The median length of hospitalization was shorter in urgent CEA [6 days (interquartile range 4-6) vs. 10 days (interquartile range 7-14); P Conclusions Our findings highlight that urgent CEA performed within 2 days from the index event is related to a non-significant increase in the risk of peri-procedural stroke. The safety of urgent CEA requires further evaluation in larger datasets.