Cardiovascular-related mortality after intraoperative neurophysiologic monitoring changes during carotid endarterectomy.
Clin Neurophysiol
; 139: 43-48, 2022 07.
Article
em En
| MEDLINE
| ID: mdl-35525076
ABSTRACT
OBJECTIVE:
We examined significant intraoperative neurophysiologic monitoring (IONM) changes and perioperative stroke as independent risk factors of long-term cardiovascular-related mortality in patients who have undergone carotid endarterectomy (CEA).METHODS:
Records of patients who underwent CEA with IONM at the University of Pittsburgh Medical Center between January 1, 2009 and December 31, 2019 were analyzed retrospectively. Cardiovascular-related mortality was compared between the significant IONM change group and no IONM change group and between the perioperative stroke group and no perioperative stroke group.RESULTS:
Our final cohort consisted of 2,090 patients. Patients with significant IONM changes showed nearly twice the rate of cardiovascular-related mortality up to 10 years post-CEA (hazard ratio (HR) = 1.98; 95% confidence interval (CI) [1.20 - 3.26]). Patients with perioperative stroke were four times more likely than patients without perioperative stroke to experience cardiovascular-related mortality (HR = 4.09; 95% CI [2.13 - 7.86]).CONCLUSIONS:
Among CEA patients who underwent CEA and who experienced significant IONM changes or perioperative stroke, we observed long-term increased and sustained risk of cardiovascular-related mortality.SIGNIFICANCE:
Significant IONM changes are valuable in predicting the risk of long-term outcomes following CEA.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Endarterectomia das Carótidas
/
Estenose das Carótidas
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Acidente Vascular Cerebral
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Monitorização Neurofisiológica Intraoperatória
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article