Carotid endarterectomy in a patient with recurrent transient ischemic attacks and burdened neurological history: A decision-making dilemma: Case report
1 Department of Surgery No.2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
2 Department of Vascular Surgery, Lviv Regional Clinical Hospital, Lviv, Ukraine.
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 17(03), 268–272.
Article DOI: 10.30574/wjbphs.2024.17.3.0141
Publication history:
Received on 12 February 2024; revised on 19 March 2024; accepted on 21 March 2024
Abstract:
Introduction: in symptomatic patients with carotid artery disease (CAD), carotid endarterectomy (CEA) reduces the risk of major stroke and is highly beneficial in patients with 70% to 99% stenosis. However, patients with burdened neurological history, risk factors, and relative contraindications for surgery require thoughtful decision-making.
Case presentation: 51-year-old male patient with a previous ischemic stroke (mRS 3) with an area of infarction that exceeds one-third of the right middle cerebral artery, who had ipsilateral carotid artery critical stenosis and contralateral near-occlusion and suffered from recurrent ipsilateral transient ischemic attacks (TIA) despite being on medical treatment. The patient underwent CEA and was discharged on postoperative day 5 with partial improvement of neurological deficit. Follow-up on postoperative day 30 was unremarkable, after which neurological improvement occurred, and the patient was successfully discharged.
Conclusion: It is possible to perform CEA in symptomatic patients with significant neurological deficits and brain lesions if conservative treatment is ineffective and there are factors indicating the necessity for surgical intervention.
Keywords:
Case report; Carotid endarterectomy; Stroke; Decision-making; Neurological deficits.
Full text article in PDF:
Copyright information:
Copyright © 2024 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0