Abstract
In this report, I reviewed lireratures and our clinical experiences of surgical revascularization ; carotid endarterectomy (CEA), intracranial embolectomy, and EC-IC bypass on emergency basis after ischemic cerebral stroke. Especially, in the cases with symptomatic and critical stenosis/complete occlusion of the internal carotid artery (ICA), current topics about efficacy and treatment algolism of emergency or ultra-emergency CEA in this clinical category. In summary ; 1) Crescendo TIAs and stroke in evolution are characteristic symptoms of the critical ICA stenosis and these cases will be absolute indication for emergency CEA. Significance of these symptoms should be more emphasized for early diagnosis in this clinical category. 2) Ultra-emergency thrombolysis and CEA should be the only successful procedure in the serious ICA occlusion group. Proper and quick examination system for true diagnosis, especially for evaluation of effectiveness and risk of surgical revascularization, must be considered.
