Objectives:To determine the diagnostic value for predicting cerebral hyperperfusion syndrome (CHS) by adding a transcranial Doppler (TCD) measurement in the early postoperative phase after carotid endarterectomy (CEA).Design: Patients who underwent carotid endarterectomy between January 2004 and August 2010 and in whom both intra-and postoperative TCD monitoring were performed were included.Methods: In 184 CEA patients the mean velocity (V mean ) preoperatively (V 1 ), pre-clamping (V 2 ), post-declamping (V 3 ) and postoperatively (V 4 ) was measured using TCD. The intra-operative V mean increase ((V 3 Ϫ V 2 )/V 2 ) was compared to the postoperative increase ((V 4 Ϫ V 1 )/V 1 ) in relation to CHS. CHS was diagnosed if the patient developed neurological complaints in the presence of a preoperative V mean increase Ͼ100%.Results: Sixteen patients (9%) had an intra-operative V mean increase Ͼ100% and 22 patients (12%) a postoperative V mean increase of Ͼ100%. In 10 patients (5%) CHS was diagnosed; two of those had an intra-operative V mean increase of Ͼ100% and nine postoperative V mean increase Ͼ100%. This results in a positive predictive value of 13% for the intra-operative and 41% for the postoperative measurement.Conclusions: Besides the commonly used intra-operative TCD monitoring additional TCD measurement in the early postoperative phase is useful to more accurately predict CHS after CEA. Unselected Percutaneous Access with Large Vessel Closure for Endovascular
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.