[Urgent and emergency carotid TEA]

Restoration of blood flow to reperfuse ischemic but not infarcted areas of the brain (ischemic penumbra) and the removal of an ongoing embolic source are the therapeutic aims of emergency and urgent carotid endarterectomy (CEA), both in patients with an acute or progressive ischemic stroke and in patients in the early period after a carotid-related stroke. Based on poor results in the 60ies and 70ies, many centers traditionally perform CEA four to six weeks after a carotid-related stroke at the earliest interval. Since natural history is associated with a high risk of an disabling and/or recurrent stroke in several subgroups of patients, some reports were able to show that urgent and emergency CEA could be worthwhile in well-selected patients.