Safety of urgent endarterectomy in acute non-disabling stroke
patients with symptomatic carotid artery stenosis: an
international multicenter study

J 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.

Basic information

Original name

Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study

Authors

ROUSSOPOULOU, A. (300 Greece); G. TSIVGOULIS (300 Greece, guarantor); C. KROGIAS (276 Germany); A. LAZARIS (300 Greece); K. MOULAKAKIS (300 Greece); G.S. GEORGIADIS (300 Greece); Robert MIKULÍK (203 Czech Republic, belonging to the institution); J.D. KAKISIS (300 Greece); C. ZOMPOLA (300 Greece); S. FAISSNER (300 Greece); M. CHONDROGIANNI (300 Greece); C. LIANTINIOTI (300 Greece); T. HUMMEEL (276 Germany); A. SAFOURIS (300 Greece); P. MATSOT (300 Greece); K. VOUMVOURAKIS (300 Greece); M. LAZARIDES (300 Greece); G. GEROULAKOS (300 Greece) and S.N. VASDEKIS (300 Greece)

Edition

European Journal of Neurology, Oxford, Rapid Science Ltd. 2019, 1351-5101

Other information

Language

English

Type of outcome

Article in a journal

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

is not subject to a state or trade secret

References:

URL

Impact factor

Impact factor: 4.516

RIV identification code

RIV/00216224:14110/19:00109548

Organization unit

Faculty of Medicine

DOI

https://doi.org/10.1111/ene.13876

UT WoS

000460307300020

EID Scopus

2-s2.0-85059054181

Keywords in English

carotid; endarterectomy; safety; stroke; TIA; urgent

Abstract

In the original language

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.

Cite

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 and S.N. VASDEKIS. Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study. European Journal of Neurology. Oxford: Rapid Science Ltd., 2019, vol. 26, No 4, p. 673-679. ISSN 1351-5101. Available from: https://doi.org/10.1111/ene.13876.

@article{1527136,
   author = {Roussopoulou, A. and Tsivgoulis, G. and Krogias, C. and Lazaris, A. and Moulakakis, K. and Georgiadis, G.S. and Mikulík, Robert and Kakisis, J.D. and Zompola, C. and Faissner, S. and Chondrogianni, M. and Liantinioti, C. and Hummeel, T. and Safouris, A. and Matsot, P. and Voumvourakis, K. and Lazarides, M. and Geroulakos, G. and Vasdekis, S.N.},
   article_location = {Oxford},
   article_number = {4},
   doi = {https://doi.org/10.1111/ene.13876},
   keywords = {carotid; endarterectomy; safety; stroke; TIA; urgent},
   language = {eng},
   issn = {1351-5101},
   journal = {European Journal of Neurology},
   title = {Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study},
   url = {http://dx.doi.org/10.1111/ene.13876},
   volume = {26},
   year = {2019}
}

TY  - JOUR
ID  - 1527136
AU  - Roussopoulou, A. - Tsivgoulis, G. - Krogias, C. - Lazaris, A. - Moulakakis, K. - Georgiadis, G.S. - Mikulík, Robert - Kakisis, J.D. - Zompola, C. - Faissner, S. - Chondrogianni, M. - Liantinioti, C. - Hummeel, T. - Safouris, A. - Matsot, P. - Voumvourakis, K. - Lazarides, M. - Geroulakos, G. - Vasdekis, S.N.
PY  - 2019
TI  - Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study
JF  - European Journal of Neurology
VL  - 26
IS  - 4
SP  - 673-679
EP  - 673-679
PB  - Rapid Science Ltd.
SN  - 13515101
KW  - carotid
KW  - endarterectomy
KW  - safety
KW  - stroke
KW  - TIA
KW  - urgent
UR  - http://dx.doi.org/10.1111/ene.13876
L2  - http://dx.doi.org/10.1111/ene.13876
N2  - 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.
ER  -

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 and S.N. VASDEKIS. Safety of urgent endarterectomy in acute non-disabling stroke patients with symptomatic carotid artery stenosis: an international multicenter study. \textit{European Journal of Neurology}. Oxford: Rapid Science Ltd., 2019, vol.~26, No~4, p.~673-679. ISSN~1351-5101. Available from: https://doi.org/10.1111/ene.13876.

Přehled o publikaci