Urgent Carotid Artery Repair: Retrospective Study of 21 Cases

Abstract

The purpose of this retrospective study was to assess the outcome of urgent surgical repair in patients with symptomatic carotid artery lesions. The study population included 21 patients who underwent carotid artery repair less than 24 hr after diagnostic work-up. Indications included crescendo transient ischemic attacks in 5 cases, fluctuating neurological deficits in 11, and stroke in evolution in 5. Immediate mortality was 9.5%. Mean follow-up was 55 months. Actuarial survival rates at 1 and 5 years were 90% and 62%, respectively. Actuarial neurological deficit-free rates at 1 and 5 years were 95% and 76%, respectively. The results of this study document the effectiveness of urgent carotid artery repair for treatment of acute cerebral ischemia. Although higher than elective surgery, morbidity and mortality are acceptable, given the severity of illness in this patient population.