[Was it necessary to treat acute carotid thromboses surgically? 1962-1973: long-term results]

A 13 years study of 22 patients with surgical treatment of acute occlusion of the internal carotid artery is reported. Mortality rate was 22% (5 patients). 35% had a complete recovery of the stroke without any sequelae. 6 were better after intervention, 3 worsened. Long term mortality is 10 patients with 2 strokes and 4 myocardial infarction. No significant difference can be observed on life table of the survivors with reference to recent medical series, 60% at five years, 36% at ten years, 28% 13 at years. A review of 30 studies of the literature (1,046 cases of acute stroke or transient ischemic attacks) shows a 17% global mortality, with 50% of good results. Mortality of surgical treatment of acute carotid occlusion is lower in recent papers (inferior 10%). This progression seems to be related to the selection of the indications of surgery in stroke (shorter delay, early diagnosis with non-invasive procedures, post-operative management). The conclusion is that a surgical therapy of acute thrombosis of the internal carotid artery cannot be systemically rejected.