Abstract
Although carotid endarterectomy (CEA) is an established treatment, evaluation of emergency revascularization is still obscure, especially in patients with stroke. The purpose of this study is to discuss the efficacy and limitation of emergency CEA. The subjects are 88 patients who had acute atherothrombotic TIAs or stroke, and angiographically critical stenosis (>90%) of the cervical ICA. A patient with apparent low-density lesion on the initial CT was not included. There were 86 men and 4 women, aged 49 to 78 years. All patients were admitted and diagnosed within 6 h after the last attack, and treated by CEA in different timing or medical treatment. Results of treatment were evaluated. In 33 patients with only TIAs, results of CEAs were excellent compared with medical treatment group. In 29 with mild neurologic deficits, results of CEAs were more satisfactory in emergency procedures in comparison with delayed surgery. In other 26 patients with profound deficits, sufficient results were not obtained in any treatments. In conclusion, emergency CEA should be selected without hesitation, in patients with critical ICA stenosis and TIAs or mild ischemic stroke. We also present our small experiences and discuss about endovascular PTA/stenting in this clinical category.
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