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© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email [email protected] Patients with symptomatic carotid stenosis remain at high risk of early recurrent stroke without revascularization. This risk must be balanced against a higher rate of periprocedural complications associated with early revascularization. OBJECTIVE To analyze prospectively recorded data from an institutional protocol that standardized the urgent ( less then 48 h) treatment of patients pre