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Aim: To assess the procedural risk of carotid endarterectomy (CEA) in relation to its timing after ischemic stroke and to define the reasons that delay surgery beyond the recommended time interval. Materials and methods: A retrospective analysis was performed using prospectively collected data from all consecutive patients with symptomatic internal carotid artery stenosis who underwent CEA during the period from January 2013 to August 2019. The patients were divided into four groups according to the timing of CEA: group 1 – CEA within 2 days; group 2 – CEA between 3–7 days; group 3 – CEA between 8–14 days; and group 4 – CEA between 15–180 days. The primary outcome measure was the combined perioperative rate of any stroke or death within 30 days. Results: A total of 246 patients were included in the study. The median time interval between stroke and CEA was 8 days. A total of 191 patients (77.6%) underwent CEA within the recommended 14-day period from ischemic stroke, whereas 55 patients (22.4%) underwent CEA more than 14 days after stroke. Medical reasons were the cause of CEA delay in only 18 out of these 55 patients. For the entire cohort, the overall 30-day rate of any stroke or death was 3.7% (9 patients out of 246). The procedural risk was 5.9% (3 patients out of 51) in group 1, 1.5% (1 patient of 68) in group 2, 5.6% (4 patients out of 72) in group 3, and 1.8% (1 patient out of 55) in group 4 (P = 0.477). Conclusion: In this study, the time interval between the stroke and CEA was not associated with significant increase of procedural risk of any stroke or death. [ABSTRACT FROM AUTHOR]

Aim: The influence of antiplatelet agents and anticoagulants on hemorrhagic complications and the development of ischaemic brain lesions during carotid endarterectomies (CEAs) was studied. Methods: During 559 CEAs antithrombotic therapy, as administrated by a referral doctor, was kept. The influence of antithrombotic therapy on the: 1. incidence of wound hematoma; 2. incidence of symptomatic intracerebral hematoma after CEA; 3. length of hospital stay; 4. incidence of new brain ischaemic lesions were studied. Results: In total, wound hematoma was found in 43 (7.69%) cases. Of those there were: 1. 2.94% in „no antithrombotic” group; 2. 5.18% (p = 0.55) in the acetylsalicylic acid (ASA)/ASA + derivates group; 3. 18.36% (p = 0.008) in clopidogrel group; 4. 0% in ticlopidin group; 5. 20% = 0.022) in low molecular weight heparin (LMWH) group; 6. 19.05% (p = 0.026) in LMWH + ASA group; 7. 36,36% (p = 0.003) in clopidogrel + ASA group. Incidence of symptomatic intracerebral hematoma after CEA was 0.89% in five cases. The mean length of hospital stay was 4.7 days for uncomplicated cases, 5.1 days for cases with hematoma without reoperation and 7.2 days for cases with hematoma with reoperation. Incidence of new ischaemic lesions after CEA was 10.91%, not related to antithrombotic therapy (p > 0.18). Conclusion: Clopidogrel, LMWH and LMWH + ASA groups showed app. 4 times higher risk of wound hematoma, dual antiplatelet therapy 5.5 times higher compared to ASA therapy only. Therefore, their use preoperatively in CEA should be restricted for cases of symptomatic stenosis with high recurrent risk of stroke. No influence of antithrombotics on the incidence of new ischaemic brain lesions dur i ng CEA was showed. Práca [ABSTRACT FROM AUTHOR]