[Emergency carotid endarterectomy in acute infarction--case report and literature review]

Elective operation of carotid stenosis over 70% is uncontested since publication of the interim results of NASCET and ECST [1,2] trials. Even though emergency carotid endarterectomy for rapidly progressing cerebral infarction (stroke in evolution) remains very controversial outcome depends on how fast cerebral perfusion is reestablished, complete recovery is possible if carotid thrombendarterectomy is successfully performed in between the first 6-8 hours. We report the case of a female patient developing a cerebral infarction on the first postoperative day after femoropopliteal bypass grafting. Diagnosis of an acute carotid occlusion was established by cerebral duplex sonography, intracerebral hemorrhage was excluded by emergency computed tomography. Emergency thrombendarterectomy successfully reverted all cerebral symptoms. Postoperative course was uneventful, the patient was dismissed on the 12th postoperative day without any neurological residual deficit.