Transient ischemic attack surgery

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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. 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.
  2. 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.
  3. 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.

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