What does this research mean for the field?

Carotid endarterectomy is associated with low perioperative stroke and mortality rates, and a pulsatility index below 0.60 in the middle cerebral artery can serve as a warning for the risk of postoperative cerebral hyperemia. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To evaluate clinical outcomes, complications, and diagnostic ultrasound methods in patients undergoing carotid endarterectomy, specifically testing if middle cerebral artery pulsatility index detects ischemia and complication risk.

June 1, 1999Acta Neurologica Scandinavica

Outcome for patients with carotid stenosis undergoing carotid endarterectomy, the cerebral condition followed by extra/intracranial ultrasound examinations

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Why the study?

What are the outcomes and complications of carotid endarterectomy, and can Doppler pulsatility index predict complications in patients with carotid stenosis?

Population

76 patients with carotid stenosis undergoing carotid endarterectomy

Design

Cohort

Follow-up

3-60 months

Authors

EEE. EnevoldsenOdense University Hospital JNJ. NørbyOdense University Hospital NRNiels RohrUniversity of Southern Denmark

Discussion

Member takes

Implication

Perioperative stroke and mortality rates align with trials; leaves open utility of pulsatility index for predicting post-endarterectomy hyperemia.

Key Points

To evaluate clinical outcomes, complications, and diagnostic ultrasound methods in patients undergoing carotid endarterectomy, specifically testing if middle cerebral artery pulsatility index detects ischemia and complication risk.
Prospective cohort study of 76 patients who underwent carotid endarterectomy between 1991 and 1996 with a follow-up of 3 to 60 months.
Evaluations included extracranial and transcranial Doppler ultrasound, Duplex imaging, angiography, and cerebrovascular reactivity testing.
Recorded outcomes included perioperative stroke, mortality, restenosis, transient ischemic attack (TIA), and middle cerebral artery (MCA) pulsatility index (PI).
Extracranial Doppler, Duplex ultrasound, and angiography showed good diagnostic correlation for detecting carotid stenosis.
Perioperative complications included a 7% stroke rate (5 of 76 patients) and a 1% mortality rate (1 of 76 patients), with hemodynamically insignificant recurrent stenosis >69% occurring in 3% of patients.
A pulsatility index below 0.60 in the middle cerebral artery indicated an elevated risk for postoperative cerebral hyperemia.

Structured PICO

What are the outcomes and complications of carotid endarterectomy, and can Doppler pulsatility index predict complications in patients with carotid stenosis?

Population

76 patients with carotid stenosis undergoing carotid endarterectomy

Intervention

Carotid endarterectomy with extra/intracranial ultrasound examinations

Outcome

Complications owing to the operation and correlation of accessible methods of examinationsafety

Carotid endarterectomy carries a 7% perioperative stroke rate, and transcranial Doppler pulsatility index <0.60 may predict postoperative cerebral hyperemia.

Cite This Study

Enevoldsen et al. (1999) studied this question.

synapsesocial.com/papers/6a19a5124b45427442ea83cc https://doi.org/10.1111/j.1600-0404.1999.tb07362.x

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Implication

Perioperative stroke and mortality rates align with trials; leaves open utility of pulsatility index for predicting post-endarterectomy hyperemia.

Outcome for patients with carotid stenosis undergoing carotid endarterectomy, the cerebral condition followed by extra/intracranial ultrasound examinations

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Outcome for patients with carotid stenosis undergoing carotid endarterectomy, the cerebral condition followed by extra/intracranial ultrasound examinations

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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