Intraluminal Shunt in Carotid Endarterectomies Increases the Risk of Ischemic Stroke

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00159816%3A_____%2F15%3A00068464" target="_blank" >RIV/00159816:_____/15:00068464 - isvavai.cz</a>

Result on the web

<a href="http://www.csnn.eu/pdf?id=51572" target="_blank" >http://www.csnn.eu/pdf?id=51572</a>

DOI - Digital Object Identifier

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Result language

čeština

Original language name

Intraluminal Shunt in Carotid Endarterectomies Increases the Risk of Ischemic Stroke

Original language description

Aim: A large prospective study compared the incidence of new ischemic lesions of brain parenchyma during carotid endarterectomies (CEA) with or without usage of an intraluminal shunt. Magnetic resonance imaging of the brain parenchyma (diffuse weighted mode, MR DW) was used to show lesions. Groups and methods: 1,019 CEA were performed during a prospective study from 2005 to 2013 at the Neurosurgery Clinic, Masaryk Hospital in Usti nad Labem. All procedures were done under regional anaesthesia with selective carotid artery shunting according to the neurological status after carotid artery branches clamping. Magnetic resonance evaluation of the brain parenchyma in diffuse weighed mode (MR DW) was performed at admission to the hospital and 24 hours after the surgical procedure. Acute new MR DW lesions were evaluated according to the classification published by Szabo et al. (Stroke 2001). Results: Serious complications (stroke, myocardial infarction, death) occurred in 3.2% of symptomatic and 1.7% of asymptomatic patients. An intraluminal shunt had to be used in 73 out of 1,019 patients (7.1%). New ischemic lesion was detected in 78 patients (7.7%). Majority of these lesions were neurologically asymptomatic (80%). New ischemic lesion on MR DW was detected in 25 (34.3%) shunted patients and in 53 (5.6%) non-shunted patients. Aetiology of the majority of these lesions involved embolization or hypoperfusion. Conclusion:The use of an intraluminal shunt during carotid endarterectomies increased the incidence of new ischemic lesions almost seven-fold. These results support our strategy to use intraluminal shunts selectively.

Czech name

Intraluminal Shunt in Carotid Endarterectomies Increases the Risk of Ischemic Stroke

Czech description

Aim: A large prospective study compared the incidence of new ischemic lesions of brain parenchyma during carotid endarterectomies (CEA) with or without usage of an intraluminal shunt. Magnetic resonance imaging of the brain parenchyma (diffuse weighted mode, MR DW) was used to show lesions. Groups and methods: 1,019 CEA were performed during a prospective study from 2005 to 2013 at the Neurosurgery Clinic, Masaryk Hospital in Usti nad Labem. All procedures were done under regional anaesthesia with selective carotid artery shunting according to the neurological status after carotid artery branches clamping. Magnetic resonance evaluation of the brain parenchyma in diffuse weighed mode (MR DW) was performed at admission to the hospital and 24 hours after the surgical procedure. Acute new MR DW lesions were evaluated according to the classification published by Szabo et al. (Stroke 2001). Results: Serious complications (stroke, myocardial infarction, death) occurred in 3.2% of symptomatic and 1.7% of asymptomatic patients. An intraluminal shunt had to be used in 73 out of 1,019 patients (7.1%). New ischemic lesion was detected in 78 patients (7.7%). Majority of these lesions were neurologically asymptomatic (80%). New ischemic lesion on MR DW was detected in 25 (34.3%) shunted patients and in 53 (5.6%) non-shunted patients. Aetiology of the majority of these lesions involved embolization or hypoperfusion. Conclusion:The use of an intraluminal shunt during carotid endarterectomies increased the incidence of new ischemic lesions almost seven-fold. These results support our strategy to use intraluminal shunts selectively.

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30103 - Neurosciences (including psychophysiology)

Project

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Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2015

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Česká a slovenská neurologie a neurochirurgie

ISSN

1210-7859

e-ISSN

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Volume of the periodical

78

Issue of the periodical within the volume

2

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

4

Pages from-to

163-166

UT code for WoS article

000352676300005

EID of the result in the Scopus database

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