title: Outcome of carotid endarterectomy for acute neurological deficit.
abstract: We reviewed our experience with urgent carotid intervention in the setting of acute neurological deficits. Between June 1992 and August 2008, a total of 3145 carotid endarterectomies (CEA) were performed. Twenty-seven patients (<1.0%) were categorized as urgent. The mean age was 74.1 years (range 56-93 years) with 16 (60%) men, and 11 (40%) women, Symptoms included extremity weakness or paralysis (n=13), amaurosis fugax (n=6), speech difficulty (n=2), and syncope, (n=3). Three patients exhibited a combination of these symptoms. Three open thrombectomy were performed. Regional anesthesia was used in 13 patients (52%). Seventeen patients (67%), required shunt placement. At 30-days, 2 patient (7%) suffered a stroke, and 1 (4%) died. Urgent CEA can be performed safely. A stroke rate of 7% is acceptable in those who may otherwise suffer a dismal outcome without intervention.
authors.affiliation: Division of Vascular and Endovascular Surgery, New York University School of Medicine, New York, NY 10016, USA. firas.mussa@nyumc.org
authors.forename: Firas F
authors.initials: FF
authors.lastname: Mussa
authors.forename: Nicole
authors.initials: N
authors.lastname: Aaronson
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Lamparello
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Maldonado
authors.forename: Neal S
authors.initials: NS
authors.lastname: Cayne
authors.forename: Mark A
authors.initials: MA
authors.lastname: Adelman
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Riles
authors.forename: Caron B
authors.initials: CB
authors.lastname: Rockman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020757:Amaurosis Fugax / Q000209:etiology; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D001184:Articulation Disorders / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D019992:Databases as Topic; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010243:Paralysis / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D020521:Stroke / Q000175:diagnosis / Q000209:etiology*; D013575:Syncope / Q000209:etiology; D017131:Thrombectomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex