Ophthalmologic Outcomes in Patients With Carotid Artery Stenosis
Study Details
Study Description
Brief Summary
The retinal vessels have been shown to reflect vascular changes inherent to systemic pathologies, even when no ocular disease is identified. As such, the eye's vasculature is ableto serve as a window to the vascular health of the human body and a means of assessing systemic endothelial function. Optical coherence tomography angiography (OCTA) employs optical means to image all the retinal vascular layers and the choroid, providing an extremely detailed image of the microvascular network in a fast, reproducible and totally non-invasive way. As such, it is currently the best non-invasive way of having an image of human capillaries. Recently, OCTA has been used to study the retinal vessels' structure and function in several cardiovascular diseases. As an example of its predictive potential, reduced retinal microvascular density has been associated with the cardiovascular risk profile in patients admitted to the hospital for an acute coronary syndrome. Recent studies have also shown the retinal microvasculature density to be reduced in patients with carotid artery disease (CAD), namely carotid stenosis, and that endarterectomy increases retinal flow and vessel density.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
The authors hypothesize that FGF-23, GDF-15, VEGF-A, MMP-9 and retinal/choroidal microvascular density could predict cerebral ischemia, postoperative complications, long term major cardiovascular events and short term ophthalmologic alterations particularly in patients developing symptomatic neurologic ischemia after circulation shutdown.
The purpose of this study is to compare different cardiac risk scores in carotid endarterectomy. The main aim of this study is to test the risk factors individually and determine its discriminatory ability. Combinations of traditional preoperative risk factors and scores will be evaluated to enhance the assessment of major adverse cardiac events in vascular surgery patients.
Establish and validate biomarkers that improve the predictive value of current risk stratification models for patients benefiting from carotid revascularization, outperform existing biomarkers, and reach clinical application standards.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Carotid endarterectomy he population corresponds to patients submitted to elective CEA. Consecutive patients from a tertiary referral center who undergo CEA for carotid artery stenosis (CS) under regional anesthesia will be prospectively recruited from September 2021 - December 2022. The expected patient follow-up will be of 2years. |
Diagnostic Test: eye - Optcial coherence tomography
pre and postoperative
|
Outcome Measures
Primary Outcome Measures
- Stroke [30 days]
diagnosed by Computer tomography and clinical examation
- optical coherence tomography - Angio [15 days before surgery]
Vessel density and distribution
- optical coherence tomography - Angio [24h after surgery]
Vessel density and distribution
- optical coherence tomography - Angio [30 days after surgery]
Vessel density and distribution
- optical coherence tomography - Angio [one year after surgery]
Vessel density and distribution
Secondary Outcome Measures
- Restenosis [2 months]
ultrasound defined - internacal carotid Velocity superior to 180 cm/s; or 250 cm/s
Eligibility Criteria
Criteria
Inclusion Criteria:
- Consecutive carotid stenosis
Exclusion Criteria:
-
blind patients
-
Radic stenosis
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Joao Rocha-Neves | Porto | Portugal | 4200-319 |
Sponsors and Collaborators
- Universidade do Porto
- Hospital Sao Joao
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
- 163-21