title: Thirty-day outcome of delayed versus early management of symptomatic carotid stenosis.
abstract: BACKGROUND
  The aim of this study was to compare outcomes of early (<15 days) versus delayed carotid endarterectomy (CEA) in symptomatic patients.
  
  
  METHODS
  All CEA procedures performed for symptomatic carotid stenosis between January 2006 and May 2010 were retrospectively reviewed. Postoperative mortality (within 30 days), stroke, and myocardial infarction (MI) rates were analyzed in the early and delayed CEA groups.
  
  
  RESULTS
  During the study period, 149 patients were included. Carotid revascularization was performed within 15 days after symptom onset in 62 (41.6%) patients and longer than 15 days after symptom onset in 87 (58.4%) patients. The mean time lapse between onset of neurological symptoms and surgery was 9.3 days (range 1-15) in the early surgery group and 47.9 days (range 16-157) in the delayed surgery group. Thirty-day combined stroke and death rates were, respectively, 1.7% and 3.5% in the early and the delayed surgery groups. Thirty-day combined stroke, death, and MI rates were, respectively, 1.7% and 5.9% in the early and the delayed surgery groups.
  
  
  CONCLUSIONS
  During the study period, the reduction of the symptom-to-knife time in application to the carotid revascularization guidelines did not impact our outcomes suggesting that early CEA achieves 30-day mortality and morbidity rates at least equivalent to those of delayed CEA.
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Charmoille
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France. Electronic address: vincenzo.brizzi@chu-bordeaux.fr.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Brizzi
authors.affiliation: Vascular Surgery Department, Padova University Hospital, Padova, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Lepidi
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Sassoust
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Roullet
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Ducasse
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Midy
authors.affiliation: Vascular Surgery Department, Bordeaux University Hospital, Bordeaux, France; Bordeaux University, Bordeaux, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Bérard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000401:mortality / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome