Analysis of results of carotid endarterectomy in acute period of ischemic stroke in patients with severe neurologic impairment

Nowadays, there is no consensus on the feasibility and safety of performing carotid endarterectomy in the acute period of ischemic stroke in patients with severe neurological deficit. Object: to analyze the results of carotid endarterectomy in patients with severe neurological deficit Rankin 4, performed within 14 days after suffering an acute cerebrovascular accident in one institution by one surgical team. Methods: in the period from 2010 to 2013, 109 carotid endarterectomy operations were performed within 2 to 14 days after ischemic stroke. Surgery was recommended for patients with neurological deficits with a grade of 1 to 4 on the Rankin scale. All operated patients were followed up for 36 months. General neurological status was assessed using a modified Rankin scale. Results: there were no cases of transformation of an ischemic stroke into a hemorrhagic one. There was one death after stroke. During the follow-up period, regression of neurological symptoms occurred in 16 (70.8%) of 24 operated patients with a deficit equal to 4 on the Rankin scale. Conclusion: despite the lack of recommendations on the possibility of performing carotid endarterectomy in patients after suffering from stroke with neurological deficit of 4 points on the modified Rankin scale, we have proved the effectiveness and expediency of performing this operation in this group of patients.