Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

Abstract

Summary:Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological fi ndings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological fi ndings were evaluated using the modifi ed Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological fi ndings after CAS which could not be explained by routine imaging methods. Keywords:Reperfusion injury, carotid artery stenting, oxidative damage, total thiol jor or minor thromboembolism by the imaging modalities after carotid artery stenting, might be the result of reperfusion injuries.Our research aimed at the underlying causes of the development of transient neurological complications that cannot be explained via imaging methods following elective CAS. We tried to show the isolated oxidative damage and the resulting clinical fi ndings following stenting in patients with asymptomatic carotid artery severe stenosis. Patients and methods Patient populationApproval for the study was received from our local ethical board. Between September 2014 and August 2016, we investigated a total of 343 consecutive severe carotid artery stenosis patients who are neurologically asymptomatic (without stroke, transient ischaemic attack or amaurosis fugax events within the previous six months). With the results of interdisciplinary consultation between the neurology and cardiovascular surgery departments, 160 patients were referred for carotid endarterectomy,

Protective Effect of Ellagic Acid in Vascular Epoxidation Damage in a Murine Model of Atherosclerosis

“…Vasodilation and contraction are maintained by vascular endothelial cells, whose damage is the pathological basis of atherosclerosis. Contractile and diastolic factors synthesized and secreted by vascular endothelial cells can maintain vasoconstrictive functions [1,2]. As an early symptom of atherosclerosis, endothelial cell injury induces the generation of pathological stress and impairs normal vasomotor functions [3].…”

Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

“…In this issue of Vasa -European Journal of Vascular Medicine Saraçoğlu et al [3] have shown the possible correlation between oxidative damage and neurological fi ndings after CAS, which could not be explained in the diff usion-weighted magnetic resonance imaging (DW-MRI). Interestingly, the authors have analysed the oxidative stress and correlated these results with the results of DW-MRI, evidencing that an impaired level of cerebral blood fl ow autoregulation, leading frequently to cerebral hyperperfusion syndrome after CAS, can better be detected with biomarkers of oxidative stress than with MRI.…”