Early Carotid Endarterectomy after Intravenous Thrombolysis for Acute Ischaemic Stroke

Bartoli, Michel; Squarcioni, C.; Nicoli, F.; Magnan, Pierre Édouard; Malikov, Sergueï; Berger, Lynn; Lerussi, G.; Branchereau, A

doi:10.1016/j.ejvs.2008.12.018

Cited by 44 publications

(36 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Consistent with this, another report by Rathenborg et al 11 also found that thrombolysis did not seem to increase the risk of serious complications in patients undergoing subsequent CEA, although a slightly higher bleeding complication rate (9%) was reported. Bartoli et al 12 also reported favorable outcomes of CEA undertaken on a median time of 8 days after thrombolysis; however, unlike the above authors, this group did report 1 hemorrhagic stroke that resulted in death. Finally, in a small series published recently consisting of 7 patients undergoing CEA after successful thrombolysis, 13 there was 1 postoperative intracranial hemorrhage but no other complications at 30 days.…”

Section: Discussionmentioning

confidence: 58%

Urgent Carotid Surgery and Stenting May Be Safe After Systemic Thrombolysis for Stroke

Koraen-Smith

Troëng

Björck

et al. 2014

Stroke

View full text Add to dashboard Cite

Background and Purpose-Early carotid surgery or stenting after thrombolytic treatment for stroke has become more common during recent years. It is unclear whether this carries an increased risk of postoperative complications and death. The aim of this nationwide population-based study was, therefore, to investigate the safety of urgently performed carotid procedures in patients treated with thrombolysis for stroke. Methods-Using the national Vascular and Stroke registries, we identified 3998 patients who had undergone carotid endarterectomy or carotid artery stenting for symptomatic carotid stenosis between May 2008 and December 2012. Among these, 2% (79 of 3998) had undergone previous thrombolysis for stroke. We conducted a retrospective review of registry data and individual case records with regard to postoperative complications, including surgical-site bleeding, stroke, and death. The outcome was compared with the results for the remaining patient cohort (3919 of 3998) undergoing carotid surgery and stenting during the study period. Results-The median time between thrombolysis and the carotid procedure was 10 days. Seventy-one patients underwent carotid endarterectomy, and 6 patients underwent carotid artery stenting. The 30-day death and stroke rate for the thrombolysis cohort was 2.5% (2 of 79), and for the whole cohort, it was 3.8% (139 of

show abstract

Section: Discussionmentioning

confidence: 58%

Urgent Carotid Surgery and Stenting May Be Safe After Systemic Thrombolysis for Stroke

Koraen-Smith

Troëng

Björck

et al. 2014

Stroke

View full text Add to dashboard Cite

show abstract

“…A similar series from Marseilles, France, described one major adverse neurological event after acute CEA: a haemorrhagic stroke 6 . The present series differed in that the majority of patients had treatment under local anaesthesia.…”

Section: Discussionmentioning

confidence: 98%

“…The present series differed in that the majority of patients had treatment under local anaesthesia. Similarly, only 6 per cent of patients who had stroke thrombolysis were suitable for CEA in Marseilles 6 .…”

Section: Discussionmentioning

confidence: 99%

“…Reanalysis of controlled trials of carotid endarterectomy (CEA) indicated that surgery conferred the greatest benefit when performed in the first 2 weeks following the index symptom, perhaps as early as 48 h after the index event 3,4 . There are few data and, therefore, little guidance regarding the safety and optimal timing of carotid intervention following thrombolytic therapy for acute stroke 5,6 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early carotid endarterectomy following thrombolysis in the hyperacute treatment of stroke

Crozier

Reid

Welch

et al. 2010

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Yet, with the increasing number of stroke units, the question of a rapid revascularization of residual ICA stenosis after thrombolysis has emerged. Recent studies reported reassuring results but they were small population studies [25][26][27][28].Among the two neurological complications in our study, one was a postoperative stroke after thrombolysis and delayed CR. We believe early CR after thrombolysis should be considered, but larger series of patients are required to con irm the safety of such management.…”

Section: Discussionmentioning

confidence: 74%

Analysis of early Versus Delayed Carotid Surgery after Acute Ischemic Stroke

Perou

2017

J Neurosci Neurol Disord

View full text Add to dashboard Cite

Objective: We evaluated the 30-day outcomes of early (≤ 14 days) or delayed (15 days to three months) carotid revascularization (CR) performed in patients who presented acute brain infarction secondary to internal carotid artery (ICA) stenosis. Methods:We included all patients with a recent cerebral infarction from July 2010 to June 2014 who underwent CR in our center within three months after the onset of symptoms for ICA stenosis. Data were retrospectively collected. Two groups were identifi ed: Group A included patients who underwent early CR within the fi rst fourteen days after symptom onset, and Group B, patients who underwent delayed CR, from the fi fteenth day up to the third month after symptom onset. Death, stroke and major adverse cardiac events (MACE) were analyzed.Results: Seventy-one patients underwent CR (73.2% men, with a median age of 71). Nineteen patients underwent early CR and 52 underwent delayed CR. The mean interval from initial examination to surgery was 9.5 days (range, 3-14 days) in Group A and 42 days (range, 15-92 days) in Group B. No complication occurred in Group A within the 30 postoperative days. In Group B, no MACE or death was observed and two patients presented with post-operative stroke (3.8%). Conclusion:This retrospective study confi rmed the satisfactory outcomes of early CR after acute brain infarct. Accurate clinical and radiological selection of patients prevents early neurological complications.

show abstract

Early Carotid Endarterectomy after Intravenous Thrombolysis for Acute Ischaemic Stroke

Cited by 44 publications

References 26 publications

Urgent Carotid Surgery and Stenting May Be Safe After Systemic Thrombolysis for Stroke

Urgent Carotid Surgery and Stenting May Be Safe After Systemic Thrombolysis for Stroke

Early carotid endarterectomy following thrombolysis in the hyperacute treatment of stroke

Analysis of early Versus Delayed Carotid Surgery after Acute Ischemic Stroke

Contact Info

Product

Resources

About