Timing of Surgery After Ischemic Stroke

Prior ischemic stroke is a strong risk factor for perioperative mortality and morbidity, including recurrent stroke and other major adverse cardiovascular events. These risks are highest in the months after stroke and decline over time. Increasing the interval between stroke and surgery may decrease the risk of perioperative complications. The benefits of delay must be weighed against the risks of postponing surgery. In this focused review, we examine 5 major studies of the timing of surgery after ischemic stroke. On the basis of this evidence, we provide a framework to guide the appropriate scheduling of surgery after stroke.