抄録
Background: The American Heart Association (AHA) recommends that carotid endarterectomy (CEA) be performed within two weeks in patients presenting with a symptomatic carotid stenosis. However, urgent CEA for acute stroke is not common because of medical resources. We carried out urgent CEA for patients with medical treatment resistance. The aim of this study was to determine the safety and benefit of urgent CEA with medical treatment resistance.
Methods: Seventy-six consecutive patients underwent CEA at the Kyushu Medical Center between April 2007 and April 2011. Medical treatment resistance was diagnosed by repeat stroke or plaque diagnosis. Survival follow-up, NIHSS and the incidence of stroke were investigated all patients.
Results: A total 15 patients in medical treatment resistance were enrolled. ICA stenosis was average NACET 56% (18–95%). The median days from event to CEA were 12 days (2–28 days). Plaque diagnosis suggested unstable plaque in all cases. There was no stroke recurrence in 30 days and no increase of NIHSS score, respectively.
Conclusions: For the patients in medical treatment resistance, urgent CEA is associated with an acceptable outcome and satisfactory benefits. Plaque diagnosis is necessary to determine medical treatment resistance.
