Open AccessMulticenter study: carotid endarterectomy in the first hours after ischemic stroke
Author(s) -
А. Н. Казанцев,
Р. А. Виноградов,
M. A. Chernyavsky,
В. Н. Кравчук,
В. В. Матусевич,
К. П. Черных,
А. Р. Шабаев,
I. N. Shukurov,
Г. Ш. Багдавадзе,
В. А. Луценко,
Р. В. Султанов,
Е. Ф. Вайман,
V. A. Pоrkhanov,
Г.Г. Хубулава
Publication year - 2021
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2021-4316
Subject(s) - medicine , stroke (engine) , carotid endarterectomy , cardiology , clinical endpoint , myocardial infarction , endarterectomy , revascularization , carotid arteries , randomized controlled trial , mechanical engineering , engineering
Aim . To analyze inhospital outcomes of carotid endarterectomy (CE) in the acute period (within 3 days from the onset) of ischemic stroke. Material and methods . This retrospective multicenter study for the period from January 2008 to August 2020 included 357 patients who underwent CE in the acute period of stroke. An interdisciplinary commission defined the revascularization timing. There were following inclusion criteria: 1. Mild neurological disorders: NIHSS stroke of 3-8; modified Rankin Scale score 61; 2. Indications for CE according to the current national guidelines; 3. Brain ischemic focus 3b bleeding, internal carotid artery thrombosis, composite endpoint (death + all strokes/TIA + MI). Silent strokes were those strokes, established according to control multi-slice computed tomography angiography, without symptoms. Results . During the in-hospital follow-up period, 8 deaths (2,24%), 5 MIs (1,4%), 6 strokes/TIAs (1,7%), 15 silent ischemic strokes (4,2%), 13 hemorrhagic transformations (3,6%), 26 silent hemorrhagic transformations (7,3%), and 6 BARC type >3b bleeding (1,7%) were recorded. Thus, the combined endpoint was 20,4% (n=73). Conclusion . Due to the high incidence of cardiovascular events, CE is not a safe operation for patients in the acute period of ischemic stroke. The stroke + mortality rate exceeding 3% demonstrates the ineffectiveness of this method of treatment.