Safety of Early Carotid Endarterectomy after Intravenous Thrombolysis in Acute Ischemic Stroke
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu srovnávací studie, časopisecké články
PubMed
28479465
DOI
10.1016/j.avsg.2017.03.195
PII: S0890-5096(16)31148-7
Knihovny.cz E-zdroje
- MeSH
- čas zasáhnout při rozvinutí nemoci * MeSH
- časové faktory MeSH
- cévní mozková příhoda diagnóza farmakoterapie etiologie mortalita MeSH
- fibrinolytika aplikace a dávkování škodlivé účinky MeSH
- intravenózní podání MeSH
- ischemie mozku diagnóza farmakoterapie etiologie mortalita MeSH
- karotická endarterektomie * škodlivé účinky mortalita MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci arterie carotis komplikace diagnostické zobrazování mortalita chirurgie MeSH
- registrace MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- trombolytická terapie * škodlivé účinky MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- fibrinolytika MeSH
BACKGROUND: The timing of carotid endarterectomy (CEA) after intravenous thrombolysis (IVT) is still a controversial issue. The aim of this study was to assess the safety of early carotid interventions in patients treated with thrombolysis for acute ischemic stroke. METHODS: A retrospective analysis was performed using prospectively collected data from consecutive patients who underwent CEA for symptomatic internal carotid artery stenosis within 14 days after the index neurological event during the period from January 2013 to July 2016. Patients who had undergone IVT before CEA were identified. The primary outcome measures were any stroke and death rate at 30 days, symptomatic intracerebral hemorrhage and surgical site bleeding requiring intervention. RESULTS: A total of 93 patients were included for the final analysis. Among these, 13 (14.0%) patients had undergone IVT before CEA while 80 (86.0%) patients had CEA only. The median time interval between IVT and CEA was 2 days (range: 0-13). A subgroup of 6 patients underwent CEA within 24 hours of administration of IVT. The 30-day combined stroke and death rate was 7.7% (1 of 13) among patients undergoing IVT before CEA and 5.0% (4 of 80) among those undergoing CEA only (P = 0.690). In the IVT group, there were no cerebral hemorrhages or significant surgical site bleeding events requiring reintervention. CONCLUSIONS: Our experience indicates that CEA performed early after IVT for acute ischemic stroke, aiming not only to reduce the risk of stroke recurrence but also to achieve neurological improvement by reperfusion of the ischemic penumbra, may be safe and can lead to favorable outcomes.
Citace poskytuje Crossref.org
