Assessment of silent brain injury in patients undergoing elective percutaneous coronary intervention due to chronic total occlusion

Uyanik, Muhammet; Yildirim, Ufuk; Avcı, Bahattin; Soylu, Korhan

doi:10.1080/14017431.2022.2150786

Scandinavian Cardiovascular Journal

2022

DOI: 10.1080/14017431.2022.2150786

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Assessment of silent brain injury in patients undergoing elective percutaneous coronary intervention due to chronic total occlusion

Muhammet Uyanik

Ufuk Yildirim

Bahattin Avcı

et al.

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2024

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Cited by 2 publications

References 47 publications

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Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures

Lenarczyk,

Proietti,

Scheitz

et al. 2024

Nat Rev Cardiol

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Over the past 50 years, the number and invasiveness of percutaneous cardiovascular procedures globally have increased substantially. However, cardiovascular interventions are inherently associated with a risk of acute brain injury, both periprocedurally and postprocedurally, which impairs medical outcomes and increases health-care costs. Current international clinical guidelines generally do not cover the area of acute brain injury related to cardiovascular invasive procedures. In this international Consensus Statement, we compile the available knowledge (including data on prevalence, pathophysiology, risk factors, clinical presentation and management) to formulate consensus recommendations on the prevention, diagnosis and treatment of acute brain injury caused by cardiovascular interventions. We also identify knowledge gaps and possible future directions in clinical research into acute brain injury related to cardiovascular interventions.

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Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures

Lenarczyk,

Proietti,

Scheitz

et al. 2024

Nat Rev Cardiol

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Evaluation of silent brain injury in patients undergoing aorto-ostial coronary stent implantation

Yildirim,

Kara,

Uyanik

et al. 2024

Annals of Medicine

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Background Aorto-ostial (AO) coronary interventions may be associated with multiple problems, including the potential embolization of atherothrombotic debris into the aorta and systemic circulation. Such embolization could theoretically lead to stroke or silent brain injury (SBI). In this study, we aimed to investigate whether there is an increased risk of SBI in patients undergoing AO stent implantation. Methods Fifty-five consecutive patients undergoing AO stenting and 55 consecutive patients undergoing non-AO stenting were included. Venous blood samples were obtained before and 12 h after the procedure to measure neuron-specific enolase (NSE), which is a sensitive marker of brain injury. Newly developed NSE elevation after the procedure in an asymptomatic patient was defined as SBI. Results SBI was detected in 24 (43.6%) patients in the AO stenting group and 17 (30.9%) patients in the non-AO stenting group ( p = .167). Although the SBI rates were statistically comparable between the groups, the presence of significant (≥50%) AO stenosis was found to be an independent predictor of SBI in multivariate logistic regression analysis [odds ratio (OR) 2.856; 95% confidence interval (CI) 1.057-7.716; p = .038]. A longer procedure time was another independent predictor for the development of SBI (OR 1.037; 95% CI 1.005-1.069; p = .023). Conclusion This study suggests that AO stenting may be associated with an increased risk of SBI if the lesion in the ostium is significant.

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Assessment of silent brain injury in patients undergoing elective percutaneous coronary intervention due to chronic total occlusion

Cited by 2 publications

References 47 publications

Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures

Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures

Evaluation of silent brain injury in patients undergoing aorto-ostial coronary stent implantation

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