[Angiomorphologic indications for emergency carotid reconstruction].
The authors examine, whether urgent carotid reconstruction is indicated, when a patient is neurologically in stable condition, but unstable angiomorphologically.


METHODS
The authors examined data about 101 patients (out of 720 carotid reconstructions). These patients had surgery for bigger than 90% stenosis on one of their internal carotid arteries, in 1998 at the Cardiovascular Department of the Semmelweis University Budapest. Nowadays reconstruction on the internal carotid artery is a routine procedure, but the indication for emergency operation is still controversial. We re-examined our emergency carotid operations in a retrospective study, in which surgery was based on angiomorphological indications. 74 patients were operated electively and 27 patients urgently. The first group waited for the operation 1-5 days, and they received preventative medical treatment. There were no preoperative TIAs. In both groups 1 perioperative TIA occurred. The authors conclude, that emergency carotid endarterectomy is not necessary based only on angiomorphological indication. Careful preoperative preparation is suggested, and until surgery anticoagulation or antiaggregation treatment is necessary. The preoperative stroke incidence at emergency carotid reconstruction is higher than is at electively operated patients.
Szabó
G V
GV
Semmelweis Egyetem, Er- és Szívsebészeti Klinika, 1122 Budapest. szabogab@hermes.sote.hu
Laczkó
A
A
Entz
L
L
D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000601:surgery; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D004638:Emergency Treatment / Q000592:standards*; D016894:Endarterectomy, Carotid / Q000592:standards*; D006801:Humans; D018579:Patient Selection; D011859:Radiography