Buchumschlag

Comparison of renin and catecholamine release in patients undergoing eversion or conventional carotid endarterectomy

Objective: The two techniques for carotid endarterectomy (CEA)— conventional (C-CEA) and eversion (E-CEA)— have different effects on blood pressure. This study compared sympathetic activity after C-CEA and E-CEA, as measured by renin and catecholamine levels. Methods: E-CEA (n ؍ 40) and C-CEA (n ؍ 3...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Demirel, Serdar (VerfasserIn) , Macek, Laura (VerfasserIn) , Attigah, Nicolas (VerfasserIn) , Hakimi, Maani (VerfasserIn) , Able, Thomas (VerfasserIn) , Böckler, Dittmar (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 30 April 2012
In: Journal of vascular surgery
Year: 2012, Jahrgang: 56, Heft: 2, Pages: 324-333
ISSN:1097-6809
DOI:10.1016/j.jvs.2012.01.051
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.jvs.2012.01.051
Verlag, Volltext: https://linkinghub.elsevier.com/retrieve/pii/S0741521412001905
Volltext
Verfasserangaben:Serdar Demirel, Laura Macek, Nicolas Attigah, Hans Bruijnen, Maani Hakimi, Thomas Able, and Dittmar Böckler
Beschreibung
Zusammenfassung:Objective: The two techniques for carotid endarterectomy (CEA)— conventional (C-CEA) and eversion (E-CEA)— have different effects on blood pressure. This study compared sympathetic activity after C-CEA and E-CEA, as measured by renin and catecholamine levels. Methods: E-CEA (n ؍ 40) and C-CEA (n ؍ 34) were performed in 74 patients with high-grade carotid stenosis. The choice of technique was made at the discretion of the operating surgeon. All patients received clonidine (150 ␮g) preoperatively. Regional anesthesia was used. The carotid sinus nerve was transected during E-CEA and preserved during C-CEA. Renin, metanephrine, and normetanephrine levels were measured preoperatively and at 24 and 48 hours postoperatively. Results: Compared with baseline, levels of renin, metanephrine, and normetanephrine decreased at 24 and 48 hours after C-CEA (P < .0001). After E-CEA, however, renin and normetanephrine levels were unchanged at 24 hours, and metanephrine levels were increased (P < .0001). At 48 hours, levels of renin (P ؍ .04), metanephrine (P < .0001), and normetanephrine (P ؍ .02) were increased. Compared with C-CEA, E-CEA was associated with significantly increased sympathetic activity at 24 and 48 hours (P < .0001). Although the use of vasodilators for postoperative hypertension did not differ in the postanesthesia care unit (E-CEA 35% vs C-CEA 18%, P ؍ .12), vasodilator use on the ward was more frequent after E-CEA (60% vs 32%, P ؍ .02). Conclusions: E-CEA appears to be associated with greater postoperative sympathetic activity and vasodilator requirements than C-CEA, findings likely related to sacrifice of the carotid sinus nerve during E-CEA but not C-CEA. ( J Vasc Surg 2012;56:324-33.)
Beschreibung:Gesehen am 27.02.2019
Beschreibung:Online Resource
ISSN:1097-6809
DOI:10.1016/j.jvs.2012.01.051

Ähnliche Einträge