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Titolo:
Stroke from carotid endarterectomy: When and how to reduce perioperative stroke rate?
Autore:
de Borst, GJ; Moll, FL; van de Pavoordt, HDWM; Mauser, HW; Kelder, JC; Ackerstaff, RGA;
Indirizzi:
St Antonius Hosp, Dept Clin Neurophysiol, NL-3430 EM Nieuwegein, Netherlands St Antonius Hosp Nieuwegein Netherlands NL-3430 EM euwegein, Netherlands St Antonius Hosp, Dept Vasc Surg, Nieuwegein, Netherlands St Antonius Hosp Nieuwegein Netherlands c Surg, Nieuwegein, Netherlands St Antonius Hosp, Dept Neurol, Nieuwegein, Netherlands St Antonius Hosp Nieuwegein Netherlands Neurol, Nieuwegein, Netherlands St Antonius Hosp, Dept Res & Dev, Nieuwegein, Netherlands St Antonius Hosp Nieuwegein Netherlands & Dev, Nieuwegein, Netherlands
Titolo Testata:
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
fascicolo: 6, volume: 21, anno: 2001,
pagine: 484 - 489
SICI:
1078-5884(200106)21:6<484:SFCEWA>2.0.ZU;2-L
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCRANIAL DOPPLER ULTRASONOGRAPHY; CEREBRAL MICROEMBOLISM; OPERATIONS; RISK; SITE;
Keywords:
carotid endarterectomy; stroke; perioperative monitoring;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Ackerstaff, RGA St Antonius Hosp, Dept Clin Neurophysiol, Postbus 2500, NL-3430 EM Nieuwegein, Netherlands St Antonius Hosp Postbus 2500 Nieuwegein Netherlands NL-3430 EM
Citazione:
G.J. de Borst et al., "Stroke from carotid endarterectomy: When and how to reduce perioperative stroke rate?", EUR J VAS E, 21(6), 2001, pp. 484-489

Abstract

Objectives: to analyse four years of CEA with respect to the underlying mechanisms of perioperative stroke and the role of intraoperative monitoring in the prevention of stroke. Patients and Methods: from January 1996 through December 1999, 599 CEAs were performed in 404 men and 195 women (mean age: 65 years, range: 39-88). All operations were performed under general anaesthesia using computerised electroencephalography (EEG) and transcranial Doppler (TCD). Any new or any extension of an existing focal cerebral deficit, as well as stroke-related death were registered. Perioperative strokes were classified by time of onset (intraoperative or postoperative), outcome (minor or major stroke), and side (ipsilateral or contralateral). Stroke aetiology was assessed intraoperatively by means of EEG, TCD, completion arteriography or immediate re-exploration, and postoperatively by duplex sonography, computerised tomography(CT) or magnetic resonance imaging (MRI) of the head. Results: perioperative stroke or death occurred in 20 (3.3%) patients. In four operations stroke was apparent immediately after surgery. Mechanisms of these strokes were ipsilateral carotid artery occlusion (1) and embolisation (3). In 16 patients stroke developed after a symptom-free interval (2-72 h, mean 18 h) due to occlusion of the internal carotid artery on the hyperperfusion syndrome (1), intracerebral haemorrhage (1), and contralateral ischaemia due to prolonged clamping (1). In three procedures the cause was unknown. Conclusions: in our experience most strokes from CEA developed after a symptom-free interval and mainly due to thromboembolism of the operated artery. We suggest the introduction of additional TCD monitoring during the immediate postoperative phase.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 00:25:37