Abstract
A emergency carotid endarterectomy can be carried out for the purpose of restoring the neurological functions or to treat high risk heart patients from a further stroke. In this regard, during the past 5 years, we have handled 12 cases that involved a carotid endarterectomy within 7 days following the latest ischemic cerebrovascular event. Six of these 12 carotid endarterectomies were performed on an emergency basis and all six patients were men : three had crecsendo transient ischemic attacks, and the remaining three had a stroke in evolution, with patterns that showed the waxing and waning of the signs and symptoms. In all cases, carotid angiography revealed severe stenosis (90% or greater) of the internal carotid artery ; additionally, ulceration was found in two cases. The average interval between the last ischemic cerebrovascular event and the carotid endarterectomy was 3 days. Postoperatively, all patient made a full recovery and no neurological deficits were noted on discharge. Surgical mortality was nil, and postoperative angiography revealed good patency of the vessel in all patients. In this series, the crecsendo transient ischemic attacks cases were thought to be caused by thromboembolic cerebral ischemia, and the cases of a stroke in evolution to hemodynamic cerebral ischemia. Based on our experience, we feel that an emergency carotid endarterectomy to be a recommendable surgical method that provides a most successful result for acute stroke patients manifesting either of the two patterns mentioned above.
