Eversion carotid endarterectomy is associated with decreased baroreceptor sensitivity compared to the conventional technique

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
Serdar DemirelNicolas Attigah

Abstract

Impairment of baroreceptor sensitivity (BRS) has been shown to be associated with blood pressure instability after carotid endarterectomy (CEA). The aim of this study was to determine whether there is a difference in postoperative BRS changes following eversion CEA (E-CEA) and conventional CEA (C-CEA). Sixty-four patients undergoing E-CEA (n = 37) and C-CEA (n = 27) were prospectively studied. Non-invasive measurements of mean arterial pressure (MAP), cardiac output (CO) and total peripheral resistance (TPR) were perioperatively obtained over three 10-min periods. Baroreflex gain was calculated as the sequential cross-correlation between heart rate and beat-to-beat systolic blood pressure. Compared with changes observed after C-CEA, E-CEA was associated with an increase in systolic pressure (SP) (P = 0.01), diastolic pressure (DP) (P = 0.008), MAP (P = 0.002) and heart rate (HR) (P = 0.03) on postoperative day 1 (POD-1). BRS decreased after E-CEA from 6.33 to 4.71 ms mmHg(-1) on POD-1 (P = 0.001) and to 5.26 ms mmHg(-1) on POD-3 (P = 0.0004). By contrast, BRS increased after C-CEA from 4.59 to 6.13 ms mmHg(-1) on POD-1 (P = 0.002) and to 6.27 ms mmHg(-1) on POD-3 (P < 0.0001). E-CEA and C-CEA have different effects on BRS. This...Continue Reading

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Citations

Jul 10, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·Aysun AltinbasUNKNOWN International Carotid Stenting Study Investigators
Nov 26, 2015·Journal of Cardiothoracic and Vascular Anesthesia·Caroline VanpeteghemStefan De Hert
May 15, 2012·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·P De Rango
Dec 3, 2014·Annals of Vascular Surgery·Terézia B AndrásiJustus Strauch
Aug 5, 2014·Journal of Vascular Surgery·Serdar DemirelDittmar Böckler
Nov 15, 2014·Wiener medizinische Wochenschrift·Mirko Hirschl, Michael Kundi
Aug 25, 2016·Annals of Vascular Surgery·Maen Aboul HosnLuigi Pascarella
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