The correlation between the increased perioperative risk of carotid endarterectomy and the neurological status
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 6
Abstract
The background of this study was a thesis, that the presence of recent neurological symptoms may be related to unstable carotid plaque. Such lesions may have a different morphological character – increasing the microembolism phenomenon, Hus increasing the perioperative risk.The aim of study was to assess, whether the patients operatem due to carotid stenosis (asymptomatic, recently symptomatic and symptomatic in the past) may differ among themselves in respekt of carotid plaque morphology, perioperative microembolism and the perioperative risk.Material and methods. 116 patients were included into the analysis. All were divided ionto 3 subgrous: asymptomatic, past symptomatic (having neurological symptoms in the past) and recently symptomatic(symptoms present within last14 days prior to operation). Following parametres were analysed: microembolism, presence of perioperative neuurological complications and the character of carotid plaque (as asssessed detailed computer analysis). The statistical analysis was performed with Kruskall-wallis and exact Fischer tests.Results. The effect of microembolism was significantly highest among the recntly symptomatic grpoup (p = 0.0001 against both other groups). Carotid plaques, as assessed by detailed computer analysis were also having a significantly higher presence of determinants of unstable carotid plaque (p = 0.0001, and p = 0.0012 against respective groups). The same relations were shown in direct morphological analysis of carotid plaques (p < 0.05 respectively)Conclusions. the degree of microembolism differs between the patients with carotid disease with regard to timing and duration of neurological symptoms. The unstable carotid plaque is much more closely related to patients with recent neurological symptoms. This may indicate a problem of precise definition of an „symptomatic patient”.
Authors and Affiliations
Grzegorz Madycki, Walerian Staszkiewicz, Witold Raciborski
Keywords
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