Transient ischemic attack surgery: Difference between revisions
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For people with a greater than 70% stenosis within the carotid artery, removal of atherosclerotic plaque by surgery, specifically a [[carotid endarterectomy]], may be recommended. | For people with a greater than 70% stenosis within the carotid artery, removal of atherosclerotic plaque by surgery, specifically a [[carotid endarterectomy]], may be recommended. | ||
==Surgery== | ==Surgery== | ||
Carotid endartectomy may be performed within 2 weeks of cerebral or retinal TIA in those with TIA attributed to a high-grade internal carotid artery stenosis: | ===Carotid Endartectomy=== | ||
Carotid endartectomy may be performed within 2 weeks of cerebral or retinal TIA in those with TIA attributed to a high-grade internal carotid artery stenosis:<ref name="pmid16912978">{{cite journal| author=Johnston SC, Nguyen-Huynh MN, Schwarz ME, Fuller K, Williams CE, Josephson SA et al.| title=National Stroke Association guidelines for the management of transient ischemic attacks. | journal=Ann Neurol | year= 2006 | volume= 60 | issue= 3 | pages= 301-13 | pmid=16912978 | doi=10.1002/ana.20942 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16912978 }} </ref><ref name="pmid24788967">{{cite journal| author=Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD et al.| title=Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. | journal=Stroke | year= 2014 | volume= 45 | issue= 7 | pages= 2160-236 | pmid=24788967 | doi=10.1161/STR.0000000000000024 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24788967 }} </ref><ref name="pmid27375548">{{cite journal| author=Yakhkind A, McTaggart RA, Jayaraman MV, Siket MS, Silver B, Yaghi S| title=Minor Stroke and Transient Ischemic Attack: Research and Practice. | journal=Front Neurol | year= 2016 | volume= 7 | issue= | pages= 86 | pmid=27375548 | doi=10.3389/fneur.2016.00086 | pmc=4901037 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27375548 }} </ref> | |||
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===Extracranial-Intracranial Bypass=== | |||
Extracranial-intracranial bypass is not recommended in patients with TIA.<ref name="pmid16912978">{{cite journal| author=Johnston SC, Nguyen-Huynh MN, Schwarz ME, Fuller K, Williams CE, Josephson SA et al.| title=National Stroke Association guidelines for the management of transient ischemic attacks. | journal=Ann Neurol | year= 2006 | volume= 60 | issue= 3 | pages= 301-13 | pmid=16912978 | doi=10.1002/ana.20942 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16912978 }} </ref> | |||
†Recommended only in certain patients and at centres with perioperative complication rate of <6% | †Recommended only in certain patients and at centres with perioperative complication rate of <6% | ||
Revision as of 21:57, 8 December 2016
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Transient ischemic attack Microchapters |
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Differentiating Transient Ischemic Attack from other Diseases |
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Transient ischemic attack surgery On the Web |
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American Roentgen Ray Society Images of Transient ischemic attack surgery |
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Risk calculators and risk factors for Transient ischemic attack surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]
Overview
For people with a greater than 70% stenosis within the carotid artery, removal of atherosclerotic plaque by surgery, specifically a carotid endarterectomy, may be recommended.
Surgery
Carotid Endartectomy
Carotid endartectomy may be performed within 2 weeks of cerebral or retinal TIA in those with TIA attributed to a high-grade internal carotid artery stenosis:[1][2][3]
| Degree of carotid artery stenosis | Carotid endartectomy |
|---|---|
| 70-99% internal carotid artery stenosis | Recommended |
| 50-69% stenosis | Recommended only in specific situation† |
| <50% stenosis | Not recommended |
Extracranial-Intracranial Bypass
Extracranial-intracranial bypass is not recommended in patients with TIA.[1]
†Recommended only in certain patients and at centres with perioperative complication rate of <6%
References
- ↑ 1.0 1.1 Johnston SC, Nguyen-Huynh MN, Schwarz ME, Fuller K, Williams CE, Josephson SA; et al. (2006). "National Stroke Association guidelines for the management of transient ischemic attacks". Ann Neurol. 60 (3): 301–13. doi:10.1002/ana.20942. PMID 16912978.
- ↑ Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD; et al. (2014). "Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association". Stroke. 45 (7): 2160–236. doi:10.1161/STR.0000000000000024. PMID 24788967.
- ↑ Yakhkind A, McTaggart RA, Jayaraman MV, Siket MS, Silver B, Yaghi S (2016). "Minor Stroke and Transient Ischemic Attack: Research and Practice". Front Neurol. 7: 86. doi:10.3389/fneur.2016.00086. PMC 4901037. PMID 27375548.