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Title: Possible determinants of early microembolism after carotid endarterectomy.
Austin Authors: Stork, Jacinda L;Levi, Christopher R;Chambers, Brian R ;Abbott, Anne L;Donnan, Geoffrey A 
Affiliation: National Stroke Research Institute, Austin and Repatriation Medical Centre, West Heidelberg, Victoria 3081, Australia
Issue Date: 1-Aug-2002
Publication information: Stroke; A Journal of Cerebral Circulation; 33(8): 2082-5
Abstract: High numbers of microembolic signals (MES) have been associated with increased risk of postoperative stroke after carotid endarterectomy (CEA). We sought to identify factors predictive of postoperative MES.Transcranial Doppler monitoring of the ipsilateral middle cerebral artery for MES was performed for 30 minutes during the first postoperative hour in sequential patients undergoing CEA. Stepwise binomial logistic regression analysis was performed to identify preoperative and intraoperative variables that predicted the occurrence of postoperative MES.We studied 141 patients (mean age, 69 years); 102 (72%) were male, and 69 (49%) had at least 1 MES (range, 1 to 118) detected in the first postoperative hour. The risk of postoperative MES was greater in women (P=0.027), patients not receiving antiplatelet therapy (P=0.033), and patients undergoing left-sided CEA (P=0.049). Other variables such as residual stenosis seen on completion angiography and operative technique were not associated with postoperative MES.Postoperative MES were most likely in women, patients not receiving preoperative antiplatelet therapy, and patients who had a left CEA. Microembolism might explain why these same factors are associated with higher rates of perioperative stroke.
Gov't Doc #: 12154267
Type: Journal Article
Subjects: Adult
Aged, 80 and over
Dextrans.therapeutic use
Endarterectomy, Carotid.adverse effects
Intracranial Embolism.etiology.prevention & control.ultrasonography
Intraoperative Period
Logistic Models
Middle Aged
Middle Cerebral Artery.ultrasonography
Monitoring, Physiologic
Multivariate Analysis
Platelet Aggregation Inhibitors.therapeutic use
Postoperative Period
Randomized Controlled Trials as Topic.statistics & numerical data
Retrospective Studies
Risk Factors
Sex Factors
Stroke.etiology.prevention & control
Ultrasonography, Doppler, Transcranial
Appears in Collections:Journal articles

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