Carotid endarterectomy in the acute phase of crescendo cerebral transient ischemic attacks is safe and effective

Abstract

Short delay between symptom onset and neurological assessment, immediate start of secondary stroke prevention, optimal perioperative medical treatment, and standardized operative techniques enabled performance of CEA in the acute phase of CcTIAs with low combined risk of stroke, death, and major cardiac event.

Carotid endarterectomy in the acute phase of stroke-in-evolution is safe and effective in selected patients

“…26 Likewise our group recently reported no symptomatic intracranial hemorrhage in 64 unstable patients, of whom 78% had a new acute brain infarction on diffusion-weighted MRI, who underwent CEA in the acute phase of crescendo cerebral TIA. 27 Furthermore, with the increasing number of stroke units where thrombolysis is being successfully performed, practitioners will have to manage patients with threatening residual cervical carotid artery stenosis and to reconsider the indications for early CEA. In this particular situation, results from this short series and others are also reassuring.…”

The need for emergency surgical treatment in carotid-related stroke in evolution and crescendo transient ischemic attack

“…Recently, some authors have demonstrated that in unstable patients emergency revascularization complication rates are quite acceptable after a strict patient selection and management protocol. [12][13][14] Currently, the consensus is lacking if unstable patients could benefit from an emergency revascularization procedure.…”

Diagnosis of and treatment for symptomatic carotid stenosis: an updated review

“…Moreover, patients with a NIHSS ≥8 had a greater reduction on their neurological deficit than those with a lower score at admission. Another recent study confirmed these data by underlining the safety and the efficacy of early surgery in the presence of multiple TIA (crescendo TIAs) owing to carotid stenosis .…”