Safety of Early Carotid Endarterectomy after Intravenous Thrombolysis in Acute Ischemic Stroke

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F17%3A10365685" target="_blank" >RIV/00216208:11150/17:10365685 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00179906:_____/17:10365685

Výsledek na webu

<a href="http://www.sciencedirect.com/science/article/pii/S0890509616311487?via%3Dihub" target="_blank" >http://www.sciencedirect.com/science/article/pii/S0890509616311487?via%3Dihub</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1016/j.avsg.2017.03.195" target="_blank" >10.1016/j.avsg.2017.03.195</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Safety of Early Carotid Endarterectomy after Intravenous Thrombolysis in Acute Ischemic Stroke

Popis výsledku v původním jazyce

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. Material and 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 prior to 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 six patients underwent CEA within 24 hours of administration of IVT. The 30 days combined stroke and death rate was 7.7% (1 of 13) among patients undergoing IVT prior to 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.

Název v anglickém jazyce

Safety of Early Carotid Endarterectomy after Intravenous Thrombolysis in Acute Ischemic Stroke

Popis výsledku anglicky

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. Material and 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 prior to 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 six patients underwent CEA within 24 hours of administration of IVT. The 30 days combined stroke and death rate was 7.7% (1 of 13) among patients undergoing IVT prior to 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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Annals of Vascular Surgery

ISSN

0890-5096

e-ISSN

—

Svazek periodika

44

Číslo periodika v rámci svazku

May

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

8

Strana od-do

353-360

Kód UT WoS článku

000415241300042

EID výsledku v databázi Scopus

2-s2.0-85020121525