Carotid artery surgery in patients with minor stroke

Of 229 carotid artery reconstructions, 67 were performed in patients after a minor stroke. In this group of patients the operative mortality was 5.9 per cent, compared with 1.8 per cent in the group of patients without preoperative minor stroke operated upon during the same period of time. The 5-year survival in the stroke group was 86 per cent and in the non-stroke group it was 65 per cent. Excluding the postoperative mortality, the survival increases to 90 and 68 per cent respectively. The difference, which is significant at 6 years (P less than 0.05), is explained by a higher incidence of coronary artery disease in the non-stroke group. The postoperative annual stroke frequency was 2.3 per cent in the stroke group and 2.4 per cent in the non-stroke group. The stroke frequency on the operated side during follow-up was 1.6 per cent per year for both groups together. It seems that a minor stroke is no contraindication to carotid artery reconstruction provided the timing of the operation is correct and other contraindications are considered.