Results of Early Endarterectomies after Transient Ischaemic Attack

Česká verzia

Authors: M. Orlický ^1,2; P. Vachata ^1,2; M. Sameš ¹
Authors place of work: Neurochirurgická klinika Masarykovy nemocnice a Univerzity J. E. Purkyně, Ústí nad Labem ¹; ICRC – Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně ²
Published in the journal: Cesk Slov Neurol N 2015; 78/111(5): 550-554
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2015550

Summary

Aim:
The importance of early endarterectomy (CEA) for secondary stroke prevention in patients after transient ischaemic attack (TIA) inspired an analysis of our data and their correlation with generally accepted recommendations to ascertain whether any improvements are needed.

Material and methods:
975 CEA were performed within a prospective study from 2006 to 2013 at the Clinic of Neurosurgery, Masaryk Hospital in Usti nad Labem. All procedures were done under regional anaesthesia. Magnetic resonance of the brain in diffusion-weighted mode was performed within 24 hours before and after the surgical procedure. 187 procedures in patients with symptomatic TIAs were analysed in detail. We focused on: 1. period (in days) from the onset of symptoms until carotid endarterectomy itself; 2. number and type of perioperative complications in relation to operation timing.

Results:
1. Since 2007, the mean symptom-to-surgery period in the all TIAs group was acceptable: 3.5–14 days. The mean values in the hemispheral TIAs group were even lower: 3–13 days. The mean symptom-to-surgery period exceeded the recommended values in the group of TIAs with amaurosis fugax (AF) only: 14–25.5 days. 2. Perioperative and early postoperative complications rate was 2.5% and was not higher in early surgeries.

Conclusion:
CEA management of post-hemispheral TIA patients by the Comprehensive Cerebrovascular Centre in Usti nad Labem in cooperation with other stroke units in Ustecky region, was in line with available recommendations with respect to timing as well as complication rate. Public should be better educated on AF in order to decrease symptom-to-surgery period for CEA in post-TIA patients.

Key words:
carotid endarterectomy timing – symptomatic stenosis – transient ischaemic attacks

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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