Influence of Eversion Endarterectomy and Patch Reconstruction on Postoperative Blood Pressure After Carotid Surgery
Meyer A, Gall C, Verdenhalven J, Lang W, Almási-Sperling V, Behrendt CA, Günther J, Rother U (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 78
Pages Range: 61-69
DOI: 10.1016/j.avsg.2021.06.019
Abstract
Background: Post carotid blood pressure fluctuation and hypertension (PEH) are associated with increased risk for adverse outcome; there is limited evidence on the impact of eversion endarterectomy (E-CEA) versus conventional endarterectomy with patch closure (C-CEA) on postoperative blood pressure course. Patients and Methods: In this retrospective observational study, 859 consecutive carotid endarterectomy procedures between 2004 and 2014 (C-CEA n = 585 vs. E-CEA n = 274), were evaluated. Pre- and postoperative blood pressure values were recorded from recovery room until third postoperative day and compared between both techniques; influences on the dichotomous target variable “at least one postoperative blood pressure peak”, that is need for postoperative vasodilators, were analyzed by a logistic regression model. Influences on postoperative systolic blood pressure were evaluated by a linear mixed effects regression model. Results: Preoperative baseline blood pressure was not different between both comparison groups. During postoperative course, significantly increased mean systolic blood pressure values in the E-CEA group from recovery room to second postoperative day (recovery room C-CEA: 129.2 mm Hg vs. E-CEA: 136.5 mm Hg; P < 0.001; first postoperative day C-CEA: 132.4 mm Hg vs. E-CEA: 139.3 mm Hg; P = 0.0002; second postoperative day C-CEA: 138.6 mm Hg vs. E-CEA: 143.1 mm Hg; P = 0.023) were observed. No hyperperfusion syndrome was detected as wells as no difference in postoperative complication rate. Frequency of antihypertensive interventions was also elevated in E-CEA group (C-CEA 22.1 % vs. E-CEA 31.8 %; P = 0.003). E-CEA (OR 1.591, 95% CI [1.146; 2.202]; P = 0.005) and presence of preoperatively elevated systolic readings (OR 1.015, 95%CI [1.006;1.024]; P < 0.001) was also associated with increased need for antihypertensive interventions. Conclusion: E-CEA was associated with significantly elevated postoperative blood pressure, compared to C-CEA. C-CEA was associated with postoperative blood pressure decrease; however, no difference as to neurologic and surgical complications was detected between both surgical techniques in clinical practice.
Authors with CRIS profile
Alexander Meyer
Department of Vascular Surgery
Christine Gall
Lehrstuhl für Biometrie und Epidemiologie
Julia Verdenhalven
Department of Surgery
Werner Lang
Department of Vascular Surgery
Veronika Almási-Sperling
Medizinische Fakultät
Josefine Günther
Department of Vascular Surgery
Ulrich Rother
Department of Vascular Surgery
Involved external institutions
Germany (DE)How to cite
APA:
Meyer, A., Gall, C., Verdenhalven, J., Lang, W., Almási-Sperling, V., Behrendt, C.A.,... Rother, U. (2022). Influence of Eversion Endarterectomy and Patch Reconstruction on Postoperative Blood Pressure After Carotid Surgery. Annals of Vascular Surgery, 78, 61-69. https://doi.org/10.1016/j.avsg.2021.06.019
MLA:
Meyer, Alexander, et al. "Influence of Eversion Endarterectomy and Patch Reconstruction on Postoperative Blood Pressure After Carotid Surgery." Annals of Vascular Surgery 78 (2022): 61-69.
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