Advanced search
1 file | 401.69 KB Add to list

Perioperative embolization load and S-100β do not predict cognitive outcome after carotid revascularization

Maarten Plessers (UGent) , Isabelle Van Herzeele (UGent) , Dimitri Hemelsoet (UGent) , Guy Vingerhoets (UGent) and Frank Vermassen (UGent)
(2016) ANNALS OF VASCULAR SURGERY. 36. p.175-181
Author
Organization
Abstract
Background: Cognitive changes after carotid revascularization have been reported in 10-20% of patients. The etiology of cognitive impairments remains largely unknown. This study evaluates the predictive value of S-100b serum values and perioperative microembolization on cognition after carotid revascularization. Methods: Forty-six patients with significant carotid stenosis underwent carotid endarterectomy (CEA, n = 26), transfemoral carotid artery stenting with distal protection (CASdp, n = 10), or transcervical carotid stenting with dynamic flow reversal (CASfr, n = 10). Twenty-six matched vascular patients without carotid stenosis were recruited as controls. All patients underwent comprehensive cognitive testing on the day before and 1 month after carotid revascularization. S-100b analysis was performed in 31 cases pre-, peri-, and 2, 6, and 24 hr after carotid surgery, and in 25 patients transcranial Doppler monitoring was done during surgery. Results: In the 3 treatment groups similar transient increases in S-100b values were observed. CASdp was associated with a higher embolic load than CEA and CASfr, while CEA was also associated with less microembolization than CASfr. Cognitive improvement or deterioration could not be predicted by S-100b or perioperative embolic load for any of the investigated cognitive domains. Conclusions: Cognitive deterioration could not be predicted using perioperative embolic load and S-100b changes. A similar inverted u-curve of the S-100b levels was observed in the 3 groups and may be caused by impairment in the blood-brain barrier during intervention, and not due to cerebral infarction. Distal protection CAS is associated with a higher embolic load than transcervical CAS using dynamic flow reversal and CEA, but the long-term impact of this higher embolic load is yet unknown. Perfusion-related measures seem promising in their ability to predict cognitive decline.
Keywords
Carotid endarterectomy, Cognitive outcome, Carotid artery stenting, Flow Reversal, Embolization, S-100β, NEURON-SPECIFIC ENOLASE, CEREBRAL-BLOOD-FLOW, TRANSCRANIAL DOPPLER, BRAIN-LESIONS, FILTER PROTECTION, RANDOMIZED-TRIAL, STENT PLACEMENT, ENDARTERECTOMY, STENOSIS, SURGERY

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 401.69 KB

Citation

Please use this url to cite or link to this publication:

MLA
Plessers, Maarten, Isabelle Van Herzeele, Dimitri Hemelsoet, et al. “Perioperative Embolization Load and S-100β Do Not Predict Cognitive Outcome After Carotid Revascularization.” ANNALS OF VASCULAR SURGERY 36 (2016): 175–181. Print.
APA
Plessers, M., Van Herzeele, I., Hemelsoet, D., Vingerhoets, G., & Vermassen, F. (2016). Perioperative embolization load and S-100β do not predict cognitive outcome after carotid revascularization. ANNALS OF VASCULAR SURGERY, 36, 175–181.
Chicago author-date
Plessers, Maarten, Isabelle Van Herzeele, Dimitri Hemelsoet, Guy Vingerhoets, and Frank Vermassen. 2016. “Perioperative Embolization Load and S-100β Do Not Predict Cognitive Outcome After Carotid Revascularization.” Annals of Vascular Surgery 36: 175–181.
Chicago author-date (all authors)
Plessers, Maarten, Isabelle Van Herzeele, Dimitri Hemelsoet, Guy Vingerhoets, and Frank Vermassen. 2016. “Perioperative Embolization Load and S-100β Do Not Predict Cognitive Outcome After Carotid Revascularization.” Annals of Vascular Surgery 36: 175–181.
Vancouver
1.
Plessers M, Van Herzeele I, Hemelsoet D, Vingerhoets G, Vermassen F. Perioperative embolization load and S-100β do not predict cognitive outcome after carotid revascularization. ANNALS OF VASCULAR SURGERY. 2016;36:175–81.
IEEE
[1]
M. Plessers, I. Van Herzeele, D. Hemelsoet, G. Vingerhoets, and F. Vermassen, “Perioperative embolization load and S-100β do not predict cognitive outcome after carotid revascularization,” ANNALS OF VASCULAR SURGERY, vol. 36, pp. 175–181, 2016.
@article{8099354,
  abstract     = {Background: Cognitive changes after carotid revascularization have been reported in 10-20% of patients. The etiology of cognitive impairments remains largely unknown. This study evaluates the predictive value of S-100b serum values and perioperative microembolization on cognition after carotid revascularization.
Methods: Forty-six patients with significant carotid stenosis underwent carotid endarterectomy (CEA, n = 26), transfemoral carotid artery stenting with distal protection (CASdp, n = 10), or transcervical carotid stenting with dynamic flow reversal (CASfr, n = 10). Twenty-six matched vascular patients without carotid stenosis were recruited as controls. All patients underwent comprehensive cognitive testing on the day before and 1 month after carotid revascularization. S-100b analysis was performed in 31 cases pre-, peri-, and 2, 6, and 24 hr after carotid surgery, and in 25 patients transcranial Doppler monitoring was done during surgery.
Results: In the 3 treatment groups similar transient increases in S-100b values were observed. CASdp was associated with a higher embolic load than CEA and CASfr, while CEA was also associated with less microembolization than CASfr. Cognitive improvement or deterioration could not be predicted by S-100b or perioperative embolic load for any of the investigated cognitive domains.
Conclusions: Cognitive deterioration could not be predicted using perioperative embolic load and S-100b changes. A similar inverted u-curve of the S-100b levels was observed in the 3 groups and may be caused by impairment in the blood-brain barrier during intervention, and not due to cerebral infarction. Distal protection CAS is associated with a higher embolic load than transcervical CAS using dynamic flow reversal and CEA, but the long-term impact of this higher embolic load is yet unknown. Perfusion-related measures seem promising in their ability to predict cognitive decline.},
  author       = {Plessers, Maarten and Van Herzeele, Isabelle and Hemelsoet, Dimitri and Vingerhoets, Guy and Vermassen, Frank},
  issn         = {0890-5096},
  journal      = {ANNALS OF VASCULAR SURGERY},
  keywords     = {Carotid endarterectomy,Cognitive outcome,Carotid artery stenting,Flow Reversal,Embolization,S-100β,NEURON-SPECIFIC ENOLASE,CEREBRAL-BLOOD-FLOW,TRANSCRANIAL DOPPLER,BRAIN-LESIONS,FILTER PROTECTION,RANDOMIZED-TRIAL,STENT PLACEMENT,ENDARTERECTOMY,STENOSIS,SURGERY},
  language     = {eng},
  pages        = {175--181},
  title        = {Perioperative embolization load and S-100β do not predict cognitive outcome after carotid revascularization},
  url          = {http://dx.doi.org/10.1016/j.avsg.2016.02.044},
  volume       = {36},
  year         = {2016},
}

Altmetric
View in Altmetric
Web of Science
Times cited: