Predicting transient ischemic attack after carotid endarterectomy: The role of intraoperative neurophysiological monitoring.
Clin Neurophysiol
; 141: 1-8, 2022 09.
Article
en En
| MEDLINE
| ID: mdl-35797873
ABSTRACT
OBJECTIVE:
Transient ischemic attacks (TIA) after carotid endarterectomy (CEA) are not well-studied. We aimed to investigate the characteristics and the predictive role of intraoperative neurophysiological monitoring (IONM) in TIA post-CEA.METHODS:
Patients who underwent CEA utilizing IONM from 2009-2020 were included. Analyses included TIA incidence, sensitivity, specificity, and predictive values of IONM, risk factor regression analyses, and mortality Kaplan Meier plots.RESULTS:
Out of 2232 patients, 46 experienced TIA, 14 of which were within 24 hours of CEA (p < 0.01). Nine of these patients displayed significant IONM changes during CEA. The odds of TIA increased with somatosensory evoked potential (SSEP) changes (Odds Ratio (OR) 2.48 95% Confidence Interval (CI) 1.14-5.4), electroencephalogram (EEG) changes (OR 2.65 95% CI 1.22-5.77), and combined SSEP/EEG changes (OR 2.98 95% CI 1.17-7.55). Patients with TIA were less likely to be alive after an average of 4.3 years (OR 0.5 95% CI 0.26-0.96).CONCLUSIONS:
The odds a patient will have TIA post-CEA are greater in patients with IONM changes. This risk is inversely related to the time post-CEA.SIGNIFICANCE:
Changes in IONM during CEA predict postoperative TIA. Post-CEA TIA may increase long-term mortality, thus further research is needed to better elucidate clinical implications of postoperative TIA.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Ataque Isquémico Transitorio
/
Endarterectomía Carotidea
/
Accidente Cerebrovascular
/
Monitorización Neurofisiológica Intraoperatoria
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Clin Neurophysiol
Asunto de la revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Año:
2022
Tipo del documento:
Article
País de afiliación:
Estados Unidos