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22. European Stroke Conference 342 Vascular surgery and neurosurgery Efficacy of endoscopic surgery for intracerebral hemorrhage S. Takasu1, K. Hattori2, E. Ito3, M. Ishida4, K. Hattori5 Department of Neurosurgery, Chubu Rosai Hospital, Nagoya, JAPAN1, Department of Neuro-surgery, Chubu Rosai Hospital, Nagoya, JAPAN2, Department of Neurosurgery, Chubu Rosai Hos-pital, Nagoya, JAPAN3, Department of Neurosurgery, Chubu Rosai Hospital, Nagoya, JAPAN4, De-partment of Neurosurgery, Chubu Rosai Hospital, Nagoya, JAPAN5 Background Surgical intervention for intracerebral hemorrhage remains a subject of controversy. But minimally invasive surgery including endoscopic surgery will improve outcomes in patients with large intrace-rebral hematomas. This study shows the efficacy of minimally invasive endoscopic surgery for the evacuation of hematoma. Methods We performed endoscopic surgery for 86 patients with intracerebral hemorrhage since 2004: 48 putaminal, 12 cerebellar, 12 caudate head, 12 subcortical, and 2 thalamic hemorrhage. Rigid scope was used for all patients, and fiver scope was used for patients with intraventricular hemorrhage. Results The mean percentage of hematoma evacuated was 84.2%. Post-operative hemorrhage was seen in 4 patients, including 2 patients with hemodialysis, 1 patient with warfarinization, and 1 patient taking antiplatelet. The mRS score at discharge were 2 in 2 patients, 3 in 4 patients, 4 in 45 patients, 5 in 29 patients, and 6 in 11 patients. Conclusion Endoscopic evacuation is safe and effective in patients with intracerebral hemorrhage at any loca-tion. None of the patients without bleeding tendency experienced post-operative hemorrhage. 466 © 2013 S. Karger AG, Basel Scientific Programme 343 Vascular surgery and neurosurgery How many carotid endarterectomies would be performed during the weekend for a 7-day TIA clinic service? Z. Babar1, I. Ali2, K. Thavanesan3, T. Davies4, S. Heath5, J. Kwan6 Department of Stroke Medicine, Royal Bournemouth Hospital, Bournemouth, UNITED KINGDOM1, Department of Stroke Medicine, Royal Bournemouth Hospital, Bournemouth, UNIT-ED KINGDOM2, Department of Stroke Medicine, Royal Bournemouth Hospital, Bournemouth, UNITED KINGDOM3, Department of Stroke Medicine, Royal Bournemouth Hospital, Bour-nemouth, UNITED KINGDOM4, Department of Stroke Medicine, Royal Bournemouth Hospital, Bournemouth, UNITED KINGDOM5, School of Health and Social Care, Bournemouth University, Bournemouth, UNITED KINGDOM6 Background Carotid endarterectomy is effective in reducing the risk of ischaemic stroke in patients with TIA or minor stroke and significant carotid stenosis. In the UK, the National Stroke Strategy encourages the development of a 7-day TIA clinic service, with carotid surgery to be performed within 48 hours of assessment. It is currently unclear how many carotid endarterectomies would need to be performed during the weekends (Saturday and Sunday) for such a 7-day TIA clinic service. Methods We collected data from 657 consecutive patients referred to our TIA clinic based in a District Gen-eral Hospital (clinic run 5-days per week) between March and November 2011. All patients were assessed by a senior stroke physician and carotid duplex performed, and all patients with carotid ste-nosis of >50% in the symptomatic side were referred to the vascular surgeons the same day. Results Of the 657 assessed at the TIA clinic, 213 patients (32%) had a confirmed diagnosis of TIA or minor stroke. Of these, 45 patients (21%) were found to have >50% stenosis of the left or right internal ca-rotid artery. 31 of these 45 patients (69%) had >50% stenosis in the symptomatic side, and all were referred to the vascular surgeons for consideration for endarterectomy. 20 of the 31 patients (65%) received a carotid endarterectomy and 11 (35%) did not; reasons documented were: inappropriate for surgery (6 patients), multiple co-morbidities (4 patients) and refusal to give consent (1 patient). Conclusion From these data, we estimate that for a 7-day TIA clinic service that assesses 1000 referrals per year, 30 carotid endarterectomies would be performed. If this workload is spread evenly throughout the week, this will equate to one endarterectomy performed every 6 weekends. More than one-third of patients referred to the vascular surgeons were not operated. This information could be useful for healthcare planners and economists.


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