Background: The aim of this pilot investigation was to see if a raised serum S100B level or a decrease in rSO2 following carotid revascularization with CEA might be used to detect neurological instability in CEA patients. Increased serum S100B levels during CEA, we hypothesized, would be linked to neurological symptoms after surgery. Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA during an 18-month period were prospectively evaluated. The cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum concentration of S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Results: The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B (P =.040). The cut-off of 22.5% of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO2 decline and neurological symptoms (P =.675). Two (3.1%) perioperative strokes occurred. Conclusions: Awake neuromonitoring has been found to provide a sensitive and direct evaluation of brain tissue perfusion and is specific to CEA under LA. Although there was a favorable connection between CEA and an increase in serum S100B protein, due to the long assessment time, serum S100B monitoring was not practicable (usually 3 hours).
| Published in | Clinical Medicine Research (Volume 11, Issue 6) |
| DOI | 10.11648/j.cmr.20221106.13 |
| Page(s) | 163-171 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Perioperative Stroke Prevention, Neuromonitoring, Carotid Stenosis, Selective Shunting
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APA Style
Makovec Matej, Mrđa Bozidar, Stirn Barbara. (2022). Biomarker of Cerebral Injury S100 During Carotid Endarterectomy. Clinical Medicine Research, 11(6), 163-171. https://doi.org/10.11648/j.cmr.20221106.13
ACS Style
Makovec Matej; Mrđa Bozidar; Stirn Barbara. Biomarker of Cerebral Injury S100 During Carotid Endarterectomy. Clin. Med. Res. 2022, 11(6), 163-171. doi: 10.11648/j.cmr.20221106.13
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Download@article{10.11648/j.cmr.20221106.13,
author = {Makovec Matej and Mrđa Bozidar and Stirn Barbara},
title = {Biomarker of Cerebral Injury S100 During Carotid Endarterectomy},
journal = {Clinical Medicine Research},
volume = {11},
number = {6},
pages = {163-171},
doi = {10.11648/j.cmr.20221106.13},
url = {https://doi.org/10.11648/j.cmr.20221106.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20221106.13},
abstract = {Background: The aim of this pilot investigation was to see if a raised serum S100B level or a decrease in rSO2 following carotid revascularization with CEA might be used to detect neurological instability in CEA patients. Increased serum S100B levels during CEA, we hypothesized, would be linked to neurological symptoms after surgery. Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA during an 18-month period were prospectively evaluated. The cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum concentration of S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Results: The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B (P =.040). The cut-off of 22.5% of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO2 decline and neurological symptoms (P =.675). Two (3.1%) perioperative strokes occurred. Conclusions: Awake neuromonitoring has been found to provide a sensitive and direct evaluation of brain tissue perfusion and is specific to CEA under LA. Although there was a favorable connection between CEA and an increase in serum S100B protein, due to the long assessment time, serum S100B monitoring was not practicable (usually 3 hours).},
year = {2022}
}
TY - JOUR T1 - Biomarker of Cerebral Injury S100 During Carotid Endarterectomy AU - Makovec Matej AU - Mrđa Bozidar AU - Stirn Barbara Y1 - 2022/12/08 PY - 2022 N1 - https://doi.org/10.11648/j.cmr.20221106.13 DO - 10.11648/j.cmr.20221106.13 T2 - Clinical Medicine Research JF - Clinical Medicine Research JO - Clinical Medicine Research SP - 163 EP - 171 PB - Science Publishing Group SN - 2326-9057 UR - https://doi.org/10.11648/j.cmr.20221106.13 AB - Background: The aim of this pilot investigation was to see if a raised serum S100B level or a decrease in rSO2 following carotid revascularization with CEA might be used to detect neurological instability in CEA patients. Increased serum S100B levels during CEA, we hypothesized, would be linked to neurological symptoms after surgery. Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA during an 18-month period were prospectively evaluated. The cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum concentration of S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Results: The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B (P =.040). The cut-off of 22.5% of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO2 decline and neurological symptoms (P =.675). Two (3.1%) perioperative strokes occurred. Conclusions: Awake neuromonitoring has been found to provide a sensitive and direct evaluation of brain tissue perfusion and is specific to CEA under LA. Although there was a favorable connection between CEA and an increase in serum S100B protein, due to the long assessment time, serum S100B monitoring was not practicable (usually 3 hours). VL - 11 IS - 6 ER -
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