| Perioperative blood pressure alterations after eversion and conventional carotid endarterectomy sustain in the midterm. | |
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MedLine Citation:
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PMID: 23354358 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: Carotid endarterectomy (CEA) is associated with a profound effect on blood pressure. The aim of this study was to evaluate 24 h ambulatory blood pressure measurement (ABPM) after eversion (E-CEA) and conventional (C-CEA) endarterectomy including a midterm follow-up. METHODS: Seventy-one patients were included in this prospective study [E-CEA (37)/C-CEA (34)]. Daytime (8 a.m. to 10 p.m.) and nighttime (10 p.m. to 8 a.m.) ABPMs were analyzed perioperatively and at midterm after a median follow-up period of 9.5 months (interquartile range (IQR) 6.4-17.8) in the E-CEA group and 11.5 months (IQR 8.3-13.6) in the C-CEA group RESULTS: Patient demographics and preoperative antihypertensive regimens were similar in the two groups. Compared with baseline, ABPM decreased on postoperative day 1 in the C-CEA group (P < 0.01) but normalized by day three. By contrast, ABPM values were unchanged on day 1 in the E-CEA group but increased above baseline on day 3 (P < 0.01). E-CEA was associated with higher ABPM on day 1 (P < 0.001 daytime, P < 0.01 nighttime) and again on day 3 (P < 0.001 daytime, P < 0.01 nighttime). The use of vasodilators was more frequent in the E-CEA group, both in the recovery room (P = 0.007) and on the ward (P = 0.004). Midterm results showed no difference of average blood pressure values, but an increased maximal blood pressure (P = 0.01 daytime) and heart rate (HR) (P = 0.006 daytime) were reached in the E-CEA group and decreased HR (P = 0.01 nighttime) in the C-CEA group. Compared with baseline [(E-CEA: median (IQR) 2 (1-3); C-CEA: median (IQR) 2 (1-3)], the number of antihypertensive medications at midterm was significantly higher in the E-CEA group [(median (IQR) 3 (2-3) vs. 2 (2-3), P = 0.002)]. In both groups, no adverse cardiovascular or cerebrovascular events during follow-up could be observed. CONCLUSION: Although the initial hypertensive effect of E-CEA diminishes during midterm follow-up, patients undergoing eversion endarterectomy keep needing more antihypertensive medications and are prone to develop higher maximal blood pressure. |
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Authors:
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Serdar Demirel; Nicolas Attigah; Hans Bruijnen; Maani Hakimi; Benedikta Burgmer; Dittmar Böckler |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-26 |
Journal Detail:
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Title: Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie Volume: - ISSN: 1435-2451 ISO Abbreviation: Langenbecks Arch Surg Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9808285 Medline TA: Langenbecks Arch Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Vascular and Endovascular Surgery, University Hospital of Ruprecht-Karls, Heidelberg, Germany, Serdar.Demirel@med.uni-heidelberg.de. |
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