Hoffmann M, Robbs J V, Abdool Carrim A T
Durban Cerebrovascular Group, University of Natal.
S Afr J Surg. 1998 May;36(2):63-7.
To determine whether timing of carotid endarterectomy (CEA) was significant in terms of morbidity and mortality for significant carotid stenosis in a prospectively evaluated cohort of patients with recent stroke.
A tailored protocol using contemporary neuro-imaging modalities including transcranial Doppler and non-invasive angiography. Standardised clinical scores, neurological deficit scores, an aetiopathogenic scale and disability stroke scales were used in the two group. Statistical analysis was done to compare differences in two groups: CEA done less than 6 weeks after stroke (group 1) and CEA done more than 6 weeks after stroke (group 2).
Patients formed part of the Durban Stroke Data Bank (N = 655), with 26 patients in group 1 (CEA a mean of 16 days after stroke) and 34 in group 2. There were no statistically significantly differences between the two groups with regard to demographic factors, clinical scales, neurological deficit scores and investigate findings. There was 1 post-CEA stroke and 1 death in each group (P = 0.781), which was not significantly different.
Timing of CEA after stroke may be unimportant with regard to mortality and morbidity in patients with relatively small stable neurological deficits. Other causative factors, as yet unclear, remain to be identified.
在一个对近期中风患者进行前瞻性评估的队列中，确定颈动脉内膜切除术（CEA）的时机对于严重颈动脉狭窄患者的发病率和死亡率是否具有重要意义。
采用一种定制方案，运用包括经颅多普勒和无创血管造影在内的当代神经影像学检查方法。两组均使用标准化临床评分、神经功能缺损评分、病因病理评分和残疾中风量表。进行统计学分析以比较两组之间的差异：中风后6周内进行CEA的患者（第1组）和中风后6周以上进行CEA的患者（第2组）。
患者来自德班中风数据库（N = 655），第1组有26例患者（CEA平均在中风后16天进行），第2组有34例。两组在人口统计学因素、临床量表、神经功能缺损评分和检查结果方面无统计学显著差异。每组各有1例CEA术后中风和1例死亡（P = 0.781），无显著差异。
对于神经功能缺损相对较小且稳定的患者，中风后CEA的时机对于死亡率和发病率可能并不重要。其他尚不明确的致病因素仍有待确定。
