Table of Contents
Journal of Angiology
Volume 2015, Article ID 686732, 8 pages
http://dx.doi.org/10.1155/2015/686732
Clinical Study

Patient Characteristics Can Influence the Incidence of Perioperative Microemboli during Carotid Artery Interventions

1Department of Surgery, Section of Vascular Surgery, Washington University School of Medicine, St Louis, MO 63110, USA
2Department of Surgery, Division of Vascular Surgery, VA St. Louis Health Care System, St. Louis, MO 63106, USA
3Department of Surgery, Division of Vascular Surgery, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
4Department of Psychiatry, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
5Department of Radiology, Stanford University, Palo Alto, CA 94305, USA
6Department of Radiology, VA Palo Alto Health Care System, Palo Alto, CA 94304, USA
7Department of Surgery, Division of Vascular Surgery, Stanford University, Palo Alto, CA 94305, USA

Received 19 November 2014; Accepted 19 January 2015

Academic Editor: Miltiadis I. Matsagkas

Copyright © 2015 Mohamed A. Zayed et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. Perioperative cerebral microembolization demonstrated on diffusion-weighted MRI (DWI) can occur following carotid endarterectomy (CEA) and carotid artery stenting (CAS). We sought to explore potential risk factors for this in the large patient cohort. Methods. We reviewed a 6-year consecutive patient cohort that received either CEA or CAS, and perioperative DWI evaluations. Results. 303 patients were reviewed, and 56 (19.4%) patients were found to have perioperative microemboli. The incidence was higher among patients who received CAS (P < 0.001). Hypertension (P = 0.03), smoking (P = 0.001), and a history of transient ischemic attacks (P = 0.04) were risk factors for microembolization. The risk was higher among CEA patients with obesity (P = 0.05), and among CAS patients with coronary artery disease (P = 0.03). Conclusion. Specific patient populations are likely more prone to develop perioperative cerebral microemboli following carotid intervention. Continued risk stratification may help decrease future perioperative cerebral microembolization rates.