Urgent Carotid Endarterectomy for Stroke: A Case Report

Urgent carotid endarterectomy (CEA) is beneficial in patients with non-disabling stroke or transient ischemic attack and significant ipsilateral carotid artery stenosis. It is recommended to be performed within 2-4 weeks of the event; however, its safety when done within 48 hours is still under investigation with potential risks of recurrent ipsilateral stroke and death being reported. This case highlights that urgent CEA done within 48 hours can result in significant neurological improvement. NICE advises within 48 hours of diagnosis and <7 days of radiological imaging while some large studies- especially a Swedish study of >2000 patients concluded an increased risk of stroke and death when performed within 48 hours. Evidence is still developing. In selected cases, this timely intervention can be the standard of care in the Caribbean setting in keeping with international best practice.