Ann Surg Treat Res.  2014 Jan;86(1):39-44. 10.4174/astr.2014.86.1.39.

Risk factor analysis of new brain lesions associated with carotid endarterectmy

• Lee JH
• Suh BY

• KMID: 2266905
• DOI: http://doi.org/10.4174/astr.2014.86.1.39

Abstract

PURPOSE
Carotid endarterectomy (CEA) is the standard treatment for carotid artery stenosis. New brain ischemia is a major concern associated with CEA and diffusion weighted imaging (DWI) is a good imaging modality for detecting early ischemic brain lesions. We aimed to investigate the surgical complications and identify the potential risk factors for the incidence of new brain lesions (NBL) on DWI after CEA.
METHODS
From January 2006 to November 2011, 94 patients who had been studied by magnetic resonance imaging including DWI within 1 week after CEA were included in this study. Data were retrospectively investigated by review of vascular registry protocol. Seven clinical variables and three procedural variables were analyzed as risk factors for NBL after CEA.
RESULTS
The incidence of periprocedural NBL on DWI was 27.7%. There were no fatal complications, such as ipsilateral disabling stroke, myocardial infarction or mortality. A significantly higher incidence of NBL was found in ulcer positive patients as opposed to ulcer negative patients (P = 0.029). The incidence of NBL after operation was significantly higher in patients treated with conventional technique than with eversion technique (P = 0.042).
CONCLUSION
Our data shows CEA has acceptable periprocedural complication rates and the existence of ulcerative plaque and conventional technique of endarterectomy are high risk factors for NBL development after CEA.

Keyword

Catorid endarterectomy; Complications; New brain lesions; Risk factors

MeSH Terms

Brain Ischemia
Brain*
Carotid Stenosis
Diffusion
Endarterectomy
Endarterectomy, Carotid
Humans
Incidence
Magnetic Resonance Imaging
Mortality
Myocardial Infarction
Retrospective Studies
Risk Factors*
Stroke
Ulcer

Figure

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  Fig. 1 Conventional carotid endarterectomy with shunt (A) and eversion carotid endarterectomy (B).

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  Fig. 2 New brain lesions on magnetic resonance diffusion weighted imaging after carotid endarterectomy.

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