Factors Affecting the Outcome of Symptomatic Carotid Stenosis Surgical Treatment in a Single-center Series

Abstract

Retrospective, single-center review between January 2010 and June 2020. We included 134 patients (93 male) with symptomatic ipsilateral carotid stenosis and ischemic brain lesions assessed by diffusion-weighted magnetic resonance brain imaging (DW-MRI) with RAPID processing underwent carotid endarterectomy (CEA). Patients who underwent CEA within 48 hours of symptoms suffered a significantly higher rate of postoperative stroke (emergent = 11%) compared with CEA between 2 and 14 days (urgent = 1.5%) and CEA after 14 days (elective = 0%). Ischemic brain lesion volume of less than 10 mL based on DW-MRI was an independent risk factor for postoperative stroke. Optimal timing for CEA is between 2 and 14 days after symptoms. Ischemic brain lesion volume of more than 10 mL is a reliable threshold value to predict adverse postoperative neurological results in patients with symptomatic carotid artery stenosis.