Stroke recurrence in patients with recently symptomatic carotid stenosis and scheduled for carotid revascularization

Background and purpose: Patients with symptomatic carotid stenosis (sCS) have a higher risk of stroke recurrence following the first ischaemic event. Guidelines recommend that patients undergo carotid revascularization (CR), preferably within 2weeks of the event. We aimed to determine the rate of stroke recurrence during hospitalization in patients who were admitted to the hospital with an acute ischaemic event and who underwent CR for recently sCS. Methods: As part of the stroke registry in Schleswig-Holstein, Germany (QugSS2; Qualitätsgemeinschaft Schlaganfallversorgung in Schleswig-Holstein), over a 4.5-year period (starting 2007) all patients (N=15 797) who were admitted to the hospital with an acute cerebral ischaemic event were included and prospectively evaluated. Results: A total of 597 (3.8%) patients (mean age, 71±10years; 30% women) underwent a CR. The median time between symptom onset and admission to hospitals was 6h. During the mean hospitalization of 10days, 30 patients (5%) suffered a stroke. The rates of stroke recurrence were higher, albeit non-significantly, in men compared with women (6% vs. 2.3%, respectively; P=0.059), and in patients admitted with ischaemic stroke compared with patients admitted with transient ischaemic attack (6.1% vs. 2%, respectively; P=0.052). The risk of stroke recurrence did not show any association with the other demographic and clinical parameters. Conclusion: The rate of stroke recurrence was 5% in patients with recently sCS who scheduled for CR. This suggests that CR should be performed immediately after presenting event to prevent stroke recurrence.