Result of 48-Hour Approach to Symptomatic Carotid Lesions in Patients With Stable Neurologic Examinations

Timing of treatment for symptomatic carotid disease has a controversial history with current guidelines recommending surgery within 48 hours up to 2 weeks. Advocating earlier endarterectomy (CEA) after stroke (cerebrovascular accident [CVA]) or while patient is having transient ischemic attacks (TIA) can potentially provide additional benefit acute patients resulting in improved and death outcomes. A single vascular group's database was queried all who received CEA between January 1988 December 2019. Groups were based on timing from onset symptoms: CEA1: hours, CEA2: 72 30 days CEA3: greater than days. Demographics, indications, outcomes recorded compared. compared using standard statistics. There 17,357 total performed 1990 until Indications lesion (1990 CVA vs 2372 TIA). Mean age 70 years (range, 31-98 years). Demographics TIA groups similar diabetes, cholesterol, tobacco use, coronary disease, renal failure. Stroke had more hypertension (P < .00001). Anesthesia cervical block 1603 (80.5 %) 2022 (85.2%) respectively remainder under general anesthesia. All CEA's eversion technique. Planned shunts 249 (12.5%) 139 (5.8%) on-demand 106 (5.3%) 98 (4.1%) TIA. Postoperative rates across CEA1, CEA2, CEA3 (3.4%, 2.5%, 2.1%; P = .2872). mortality demonstrated that operated increased risk mortality: (0%, 0.8%, .0215). (1.1%, 0.9%; .9190). 0.5%, 0%; .661). Stable improving exams small strokes symptoms likely undergo safely good Senior-level support may play large role overall be an increase when performing are out their initial infarction.