The case for urgent carotid endarterectomy.

The high mortality rate previously reported and the absence of proven advantage of urgent carotid endarterectomy over natural history, has discouraged consideration of this operation. We want to report on two patients with stroke in evolution and fluctuating stroke, who underwent immediate surgery with excellent results. With these cases we aim to demonstrate that selected patients with stroke in evolution or fluctuating stroke due to recent carotid thrombosis have a good prognosis after emergency surgery. We think that in these selected cases endovascular therapy is at this moment a waste of time.