Dextran reduces embolic signals after carotid endarterectomy

Area of Science:

• Neurosurgery
• Vascular Surgery
• Pharmacology

Background:

• Carotid endarterectomy (CEA) is a procedure to remove plaque from carotid arteries.
• Embolic signals detected post-CEA can indicate a risk of stroke.

Purpose of the Study:

• To evaluate the effect of 10% dextran 40 on reducing embolic signals after CEA.

Main Methods:

• 150 patients undergoing CEA were randomized to receive intravenous 10% dextran 40 or placebo.
• Transcranial Doppler monitoring of the middle cerebral artery was performed postoperatively.

Main Results:

• Embolic signals were detected in 57% of placebo vs. 42% of dextran patients within 1 hour post-op (p=0.052).
• Embolic signal counts were 46% lower in the dextran group within 1 hour.
• Between 2-3 hours post-op, embolic signals were present in 45% of placebo vs. 27% of dextran patients (p=0.040).
• Embolic signal counts were 64% lower in the dextran group at 2-3 hours.

Conclusions:

• Intravenous 10% dextran 40 reduces embolic signals within 3 hours after carotid endarterectomy.
• Dextran may play a role in neuroprotection by mitigating embolic events post-CEA.