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[Surgical treatment of cerebral ischemia. Indications for surgery in carotid artery stenosis (author's transl)].

Reconstruction of carotid arteries should preferably be a prophylactic measure and only in exceptional cases a therapeutic procedure. The best results are seen in stage I (asymptomatic) or in stage II (transient ischemic attacks). Surgical intervention in acute cerebral vascular insufficiency is indicated only with a conscious patient with a negative brain scan and without progressing symptoms (stage III a). In stage IIIb (progressive stroke) and stage IVa (acute completed stroke) operative treatment is contraindicated because of a high mortality rate. In accidents with persisting neurologic symptoms (completed stroke more than 2 weeks old) necessary reconstruction of the contralateral vessel is indicated.