A case report of transient ischemic attack with carotid artery stenosis and discussion on the need for carotid endarterectomy

Abstract

Carotid endarterectomy is common vascular procedure for atherosclerosis of carotid artery. Usually, it is done when the artery is narrowed more than 80% but it can be done even when it is narrowed 50 % if it produces symptoms. Carotid endarterectomy (CEA) is delayed 6 to 8 weeks after acute stoke, as the stroke can be progressive. Carotid endarterectomy (CEA) is done after optimal recovery from the stroke by the patient. The recovery depends on the preoperative size of the infarct and the neurological deficit. Emergency endarterectomy can be done when there is fluctuating neurological deficits due to acute carotid artery obstruction. CEA is contraindicated when the patient’s general condition is poor due to other serious illness which shorten life expectancy. It is not done in a case of major stroke as the recovery may not satisfactory.