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Cardiovascular-related mortality after intraoperative neurophysiologic monitoring changes during carotid endarterectomy.

Authors :
Paras S
Mina A
Crammond DJ
Visweswaran S
Anetakis KM
Balzer JR
Shandal V
Thirumala PD
Source :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology [Clin Neurophysiol] 2022 Jul; Vol. 139, pp. 43-48. Date of Electronic Publication: 2022 Apr 22.
Publication Year :
2022

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).<br />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.<br />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]).<br />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.<br />Significance: Significant IONM changes are valuable in predicting the risk of long-term outcomes following CEA.<br />Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2022 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

Details

Language :
English
ISSN :
1872-8952
Volume :
139
Database :
MEDLINE
Journal :
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
Publication Type :
Academic Journal
Accession number :
35525076
Full Text :
https://doi.org/10.1016/j.clinph.2022.04.005