Summary:Background: After carotid artery stenting (CAS), neurological complications that cannot be explained with imaging methods may develop. In our study we aimed to show, using oxidative stress markers, isolated oxidative damage and resulting neurological fi ndings following CAS in patients with asymptomatic carotid artery stenosis. Patients and methods: We included 131 neurologically asymptomatic patients requiring CAS. The neurological fi ndings were evaluated using the modifi ed Rankin Scale (mRS) prior to the procedure, one hour post-procedure, and two days after. Patients with elevated mRS scores but with or without typical hyperintense lesions observed on an MRI and with changes of oxidative stress marker levels at the time (Δtotal-thiol, Δtotal antioxidative status [TAS], and Δtotal oxidant status [TOS]) were evaluated. Results: In the neurological examination carried out one hour prior to the procedure, there were 92 patients with mRS = 0, 20 with mRS = 1, and 12 with mRS = 2. When Δtotal-thiol, ΔTAS, and ΔTOS values and the mRS were compared, it was observed that as the difference in oxidative parameters increased, clinical deterioration also increased proportionally (p = 0.001). Conclusions: We demonstrate a possible correlation between oxidative damage and neurological fi ndings after CAS which could not be explained by routine imaging methods.
Keywords:Reperfusion injury, carotid artery stenting, oxidative damage, total thiol jor or minor thromboembolism by the imaging modalities after carotid artery stenting, might be the result of reperfusion injuries.Our research aimed at the underlying causes of the development of transient neurological complications that cannot be explained via imaging methods following elective CAS. We tried to show the isolated oxidative damage and the resulting clinical fi ndings following stenting in patients with asymptomatic carotid artery severe stenosis.
Patients and methods
Patient populationApproval for the study was received from our local ethical board. Between September 2014 and August 2016, we investigated a total of 343 consecutive severe carotid artery stenosis patients who are neurologically asymptomatic (without stroke, transient ischaemic attack or amaurosis fugax events within the previous six months). With the results of interdisciplinary consultation between the neurology and cardiovascular surgery departments, 160 patients were referred for carotid endarterectomy,