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Cerebral microembolism and ischemic changes associated with carotid endarterectomy
N L Cantelmo1, V L Babikian, R N Samaraweera
1Department of Surgery, Boston University School of Medicine, Boston Veterans Administration Medical Center, Mass 02130, USA.
Journal of Vascular Surgery
|July 4, 1998
Summary
Postoperative microembolic signals (MS) detected during carotid endarterectomy (CEA) correlate with silent ischemic changes on MRI. Monitoring MS in the recovery room can predict these MRI findings.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Carotid endarterectomy (CEA) is a procedure to prevent stroke.
- Microembolic signals (MS) can occur during CEA.
- Understanding MS is crucial for patient outcomes.
Purpose of the Study:
- To characterize microembolic signals (MS) during carotid endarterectomy (CEA).
- To investigate the relationship between MS and postoperative magnetic resonance imaging (MRI) changes.
Main Methods:
- Retrospective analysis of 78 CEAs in 76 patients.
- Perioperative transcranial Doppler monitoring and MRI.
- Analysis of MS types and rates during surgical phases.
Main Results:
- MS were detected in 95% of CEAs.
- 1.3% of patients experienced clinical stroke.
- 9.0% of postoperative MRIs showed silent ischemic changes.
- MS rates >5 per 15 minutes in recovery room correlated with MRI changes (p < 0.0001).
Conclusions:
- Postoperative MS are linked to ischemic changes on MRI after CEA.
- MS monitoring may help identify patients at risk for cerebral ischemia.