Eversion carotid endarterectomy is associated with decreased baroreceptor sensitivity compared to the conventional technique
Objective: 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 conventiona...
Gespeichert in:
| Hauptverfasser: | , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
8 May 2012
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| In: |
European journal of vascular and endovascular surgery
Year: 2012, Jahrgang: 44, Heft: 1, Pages: 1-8 |
| ISSN: | 1532-2165 |
| DOI: | 10.1016/j.ejvs.2012.04.009 |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1016/j.ejvs.2012.04.009 Verlag, Volltext: https://linkinghub.elsevier.com/retrieve/pii/S1078588412002493 
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| Verfasserangaben: | S. Demirel, L. Macek, H. Bruijnen, M. Hakimi, D. Böckler, N. Attigah |
MARC
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| 245 | 1 | 0 | |a Eversion carotid endarterectomy is associated with decreased baroreceptor sensitivity compared to the conventional technique |c S. Demirel, L. Macek, H. Bruijnen, M. Hakimi, D. Böckler, N. Attigah |
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| 520 | |a Objective: 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). Methods: Sixty-four patients undergoing E-CEA (n ¼ 37) and C-CEA (n ¼ 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. Results: Compared with changes observed after C-CEA, E-CEA was associated with an increase in systolic pressure (SP) (P ¼ 0.01), diastolic pressure (DP) (P ¼ 0.008), MAP (P ¼ 0.002) and heart rate (HR) (P ¼ 0.03) on postoperative day 1 (POD-1). BRS decreased after E-CEA from 6.33 to 4.71 ms mmHgÀ1 on POD-1 (P ¼ 0.001) and to 5.26 ms mmHgÀ1 on POD-3 (P ¼ 0.0004). By contrast, BRS increased after CCEA from 4.59 to 6.13 ms mmHgÀ1 on POD-1 (P ¼ 0.002) and to 6.27 ms mmHgÀ1 on POD-3 (P < 0.0001). Conclusion: E-CEA and C-CEA have different effects on BRS. This is associated with an altered haemodynamic behaviour after E-CEA and C-CEA, respectively. These findings are likely the result of carotid sinus nerve interruption during E-CEA and preservation with C-CEA. | ||
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