Symptomatic Carotid Stenosis and Short-Term Recurrent Stroke Risk

Guidelines recommend carotid revascularization within 2 weeks after a stroke or transient ischemic attack (TIA) in most patients with ≥50% carotid stenosis, because data from randomized trials suggest less benefit if surgery is delayed. However, studies have suggested that the risk for recurrent stroke is high within days of the initial symptoms, raising concern that even 2 weeks' delay until surgery may be too long. Therefore, researchers prospectively studied a community-based cohort with symptomatic carotid stenosis to determine the risk for recurrent stroke within the 2-week window after presentation.

Of 314 patients with ischemic stroke, 36 had carotid stenosis. Only eight of the 36 underwent carotid revascularization, seven of them aft…