Please use this identifier to cite or link to this item: https://hdl.handle.net/1/1581
Full metadata record
DC FieldValueLanguage
dc.contributor.authorBourke, Victor-
dc.contributor.authorBourke, Bernard-
dc.contributor.otherBeiles, C.B.-
dc.date.accessioned2019-08-08T01:56:48Zen
dc.date.available2019-08-08T01:56:48Zen
dc.date.issued2016-02-
dc.identifier.citationVolume 51, Issue 2, pp. 167 - 173en
dc.identifier.issn1078-5884en
dc.identifier.urihttps://elibrary.cclhd.health.nsw.gov.au/cclhdjspui/handle/1/1581en
dc.description.abstractOBJECTIVES: The aim was to analyse a prospective, consecutive series of awake carotid endarterectomy (CEA) patients undergoing, when possible, pre- and postoperative diffusion-weighted magnetic resonance imaging brain scans (DWI). METHODS: All CEA patients from June 23, 2006, to January 13, 2012, were prospectively entered in the study. CEA was performed under regional cervical block. Only patients demonstrating shunt dependence were shunted. Before August 7, 2008, all longitudinal endarterectomy had been performed with a vein patch. From that date all CEA were eversions without a patch, except shunted patients who were vein patched. DWI was performed 2 days before and 5 days after (3 Tesla). Scans were reported by MRI-trained radiologists. Logistic regression analysis (LRA) identified predictive variables for MRI changes using backward stepwise elimination of variables with p > .05. RESULTS: There was a total of 295 consecutive CEA. There were no deaths but four clinical strokes (1.4 %); 89 excluded from DWI leaving 206; of these 27 (13%) developed new DWI lesions including four of 57 (7%) in the asymptomatic group and 23 of 149 (15%) symptomatic patients. Nineteen of the 206 (9.2%) were shunted. LRA showed that shunt dependence was highly associated with new DWI lesions: odds ratio (OR) 6.43; 95% confidence interval (CI) 2.3-17.9; p < .001. Both the vein patched, non-shunted group (OR .25; CI 0.09-0.72; p = .010) and the eversion (all non-shunted and all non-patched) group (OR 0.05; CI 0.01-0.22; p < .001) were associated with a low risk of new lesions, with the eversion group a lower risk than the patched group. CONCLUSIONS: One in every eight CEA patients developed new DWI lesions (rate doubled in symptomatic patients). Shunt dependence in conscious CEA patients is highly associated with the development of new DWI lesions compared with non-shunted patients. For non-shunted patients the new lesion risk is low, and in those patients the risk in the eversion group is lower than in the patched group.en
dc.description.sponsorshipVascular Surgeryen
dc.subjectVascular Surgical Proceduresen
dc.titleOperative Factors Associated with the Development of New Brain Lesions During Awake Carotid Endarterectomyen
dc.typeJournal Articleen
dc.identifier.doi10.1016/j.ejvs.2015.08.022en
dc.description.pubmedurihttps://www.ncbi.nlm.nih.gov/pubmed/26432259en
dc.identifier.journaltitleEuropean Journal of Vascular and Endovascular Surgeryen
dc.relation.orcidhttps://orcid.org/0000-0002-9255-390Xen
dc.originaltypeTexten
item.fulltextNo Fulltext-
item.cerifentitytypePublications-
item.openairetypeJournal Article-
item.grantfulltextnone-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
Appears in Collections:Health Service Research
Show simple item record

Page view(s)

22
checked on Feb 24, 2024

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.