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Cerebral revascularisation in stroke prophylaxis

J S Lumley

    Annals of the Royal College of Surgeons of England
    |September 1, 1980
    PubMed
    Summary
    This summary is machine-generated.

    Carotid endarterectomy can cause blood pressure instability due to carotid baroreceptor function changes. Risk factors for complications include hypertension and severe carotid artery disease, leading to the

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    Area of Science:

    • Neurosurgery
    • Vascular Surgery
    • Neurology

    Background:

    • Cerebral vascular operations, primarily carotid endarterectomies, are performed for stroke prophylaxis.
    • Postoperative blood pressure instability is a notable complication of carotid endarterectomy.

    Purpose of the Study:

    • To investigate the relationship between carotid baroreceptor function and postoperative blood pressure changes after carotid endarterectomy.
    • To identify risk factors for complications following carotid endarterectomy.
    • To evaluate the outcomes of extracranial-intracranial revascularization procedures.

    Main Methods:

    • Per-operative carotid sinus nerve recording to assess baroreceptor function.
    • Computer analysis of complications in 425 carotid endarterectomies.

    Related Experiment Videos

  • Review of carotid angiograms in 200 patients to assess disease severity.
  • Analysis of 79 extracranial-intracranial revascularization procedures.

    • Main Results:

    • Carotid sinus nerve activity correlated with post-endarterectomy changes in carotid sinus mechanical properties.
    • Hypertension, contralateral internal carotid artery disease, and lower limb vascular disease were identified as risk factors for carotid endarterectomy complications.
    • Severe bilateral internal carotid artery stenosis or occlusion was associated with all severe complications, leading to the concept of the 'reperfusion syndrome'.
    • Extracranial-intracranial revascularization showed very low morbidity.

    Conclusions:

    • Postoperative hypotension after carotid endarterectomy can be managed by local anesthetic near the carotid sinus nerve.
    • The severity of internal carotid artery disease is a critical factor in operative complications.
    • Extracranial-intracranial revascularization appears to have a low complication rate, but long-term efficacy for stroke and dementia requires further study.