Carotid endarterectomy reduces the risk of stroke in patients with symptomatic carotid artery stenosis, but the optimum time to perform surgery has been uncertain. A large study has shown that surgery within 2 days of stroke or transient ischaemic attack has an unacceptable complication rate, but is safe thereafter.
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References
Stromberg, S. et al. Very urgent carotid endarterectomy confers increased procedural risk. Stroke 43, 1331–1335 (2012).
Barnet, H. J. et al. Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N. Engl. J. Med. 339, 1415–1425 (1998).
[No authors listed] Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351, 1379–1987 (1998).
Rothwell, P. M. et al. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 363, 915–924 (2004).
Royal College of Physicians Intercollegiate Stroke Working Party. National Clinical Guidelines for Stroke, 3rd edn (Royal College of Physicians, London, 2008).
Sacco, R. L. et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention: the American Academy of Neurology affirms the value of this guideline. Stroke 37, 577–617 (2006).
European Stroke Organisation (ESO) Executive Committee & ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack 2008. Cerebrovasc. Dis. 25, 457–507 (2008).
Rantner, B., Pavelka, M., Posch, L., Schmidauer, C. & Fraedrich, G. Carotid endarterectomy after ischaemic stroke—is there a justification for delayed surgery? Eur. J. Vasc. Endovasc. Surg. 30, 36–40 (2005).
Salem, M. K. et al. Rapid access carotid endarterectomy can be performed in the hyperacute period without a significant increase in procedural risks. Eur. J. Vasc. Endovasc. Surg. 41, 222–228 (2011).
Rerkasem, K. & Rothwell, P. M. Systematic review of the operative risks of carotid endarterectomy for recently symptomatic stenosis in relation to the timing of surgery. Stroke 40, e564–e572 (2009).
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Kennedy, F., Brown, M. Optimization of the timing of carotid endarterectomy. Nat Rev Neurol 8, 367–368 (2012). https://doi.org/10.1038/nrneurol.2012.116
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DOI: https://doi.org/10.1038/nrneurol.2012.116