Eversion carotid endarterectomy is associated with impaired postoperative hemodynamic stability compared with the conventional technique

Ann Vasc Surg. 2012 Aug;26(6):755-65. doi: 10.1016/j.avsg.2011.12.015. Epub 2012 Jun 22.

Abstract

Background: Carotid endarterectomy is associated with a profound effect on blood pressure. The aim of this study was to evaluate 24-hour ambulatory blood pressure measurements (ABPMs) after eversion carotid endarterectomy (E-CEA) and conventional carotid endarterectomy (C-CEA).

Methods: Seventy-one patients were included in this prospective study (E-CEA [37]/C-CEA [34]). Daytime (8 AM-10 PM) and nighttime (10 PM-8 AM) ABPMs were analyzed preoperatively and on postoperative days 1 and 3.

Results: Patients' 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 3. 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 (daytime: P < 0.001; nighttime: P < 0.01) and again on day 3 (daytime: P < 0.001; nighttime: P < 0.01). 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).

Conclusion: E-CEA may be associated with higher postoperative blood pressure and the need for more additional antihypertensive therapy in the postoperative period compared with C-CEA.

Publication types

  • Retracted Publication

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure
  • Blood Pressure Monitoring, Ambulatory
  • Carotid Artery, Internal / diagnostic imaging
  • Carotid Artery, Internal / surgery*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / surgery*
  • Endarterectomy, Carotid / adverse effects*
  • Endarterectomy, Carotid / methods*
  • Female
  • Germany
  • Hemodynamics* / drug effects
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Linear Models
  • Male
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Vasodilator Agents / therapeutic use

Substances

  • Antihypertensive Agents
  • Vasodilator Agents