Risk Factors for Complications After Carotid Endarterectomy
Study Details
Study Description
Brief Summary
This study may determine the incidence of complications that occur after patients undergo a surgery called Carotid Endarterectomy (CEA), which is a surgery that aims to decrease the risk of strokes in patients with a condition called carotid stenosis. Medical records will be accessed to find any information pertaining to postoperative complications. Additionally, it may determine the cognitive dysfunction of patients undergoing CEA, assessed by Mini Mental Status Examination (MMSE).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This is a multicenter prospective observational study; data will be collected from two sites:
the lead site in Columbus, Ohio, USA and an international site in Girona, Spain for a total of 354 patients. The objective of this study is to determine the incidence of complications that occur after patients undergo a surgery called Carotid Endarterectomy (CEA), which is a surgery that aims to decrease the risk of strokes in patients with a condition called carotid stenosis. Patients who undergo CEA are at increased risk of cardiovascular complications because of the high incidence of coexisting heart disease, high blood pressure, and diabetes. Common complications that occur after CEA are wound hematoma (collection of blood at the wound) and intracerebral hemorrhage (bleeding in the brain). Medical records will be accessed to find any information pertaining to postoperative complications. Another objective of this study is to determine the cognitive dysfunction of patients undergoing CEA. This will be measured by a Mini Mental Status Examination (MMSE) which will occur in person before the surgery and 30 days after the surgery over the phone. This study may provide data that will help identify how to optimize recovery for future CEA patients.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| carotid endarterectomy group patients undergoing carotid endarterectomy |
Procedure: Carotid endarterectomy
Patients will undergo a surgery called carotid endarterectomy where a surgeon will remove material that causes carotid stenosis (i.e. plaque)
Other Names:
Diagnostic Test: Mini Mental Status Examination
Short questionnaire used to diagnose cognitive dysfunction
Other Names:
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Outcome Measures
Primary Outcome Measures
- Complication rate [30 days]
Incidence of postoperative complications and identify the associated risk factors.
Secondary Outcome Measures
- Cognitive Dysfunction [30 days]
the incidence of cognitive dysfunction based on Mini Mental Status Examination
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients males or females, 18 years of age and older
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Scheduled to undergo Carotid Endarterectomy
Exclusion Criteria:
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Pregnant women
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Incarcerated individuals
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Patients not able to consent for themselves
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Any disease or condition deemed by the investigator to disqualify the patient
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Participating in any interventional clinical trial
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | The Ohio State University Wexner Medical Center | Columbus | Ohio | United States | 43210 |
| 2 | Hospital Universitari de Girona Dr. Josep Trueta | Girona | Catalonia | Spain | 17007 |
Sponsors and Collaborators
- Ohio State University
- Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta
Investigators
- Principal Investigator: Sergio Bergese, MD, The Ohio State University Wexner Medical Center Department of Anesthesiology
Study Documents (Full-Text)
None provided.More Information
Publications
- Aronson S, Dyke CM, Stierer KA, Levy JH, Cheung AT, Lumb PD, Kereiakes DJ, Newman MF. The ECLIPSE trials: comparative studies of clevidipine to nitroglycerin, sodium nitroprusside, and nicardipine for acute hypertension treatment in cardiac surgery patients. Anesth Analg. 2008 Oct;107(4):1110-21. doi: 10.1213/ane.0b013e31818240db.
- Asiddao CB, Donegan JH, Whitesell RC, Kalbfleisch JH. Factors associated with perioperative complications during carotid endarterectomy. Anesth Analg. 1982 Aug;61(8):631-7.
- Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995 May 10;273(18):1421-8.
- Ericsson H, Bredberg U, Eriksson U, Jolin-Mellgård A, Nordlander M, Regårdh CG. Pharmacokinetics and arteriovenous differences in clevidipine concentration following a short- and a long-term intravenous infusion in healthy volunteers. Anesthesiology. 2000 Apr;92(4):993-1001.
- Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, Taylor DW, Haynes RB, Finan JW, Hachinski VC, Barnett HJ. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999 Sep;30(9):1751-8.
- Karapanayiotides T, Meuli R, Devuyst G, Piechowski-Jozwiak B, Dewarrat A, Ruchat P, Von Segesser L, Bogousslavsky J. Postcarotid endarterectomy hyperperfusion or reperfusion syndrome. Stroke. 2005 Jan;36(1):21-6. Epub 2004 Dec 2.
- Kunkel JM, Gomez ER, Spebar MJ, Delgado RJ, Jarstfer BS, Collins GJ. Wound hematomas after carotid endarterectomy. Am J Surg. 1984 Dec;148(6):844-7.
- McCollum PT, da Silva A, Ridler BD, de Cossart L. Carotid endarterectomy in the U.K. and Ireland: audit of 30-day outcome. The Audit Committee for the Vascular Surgical Society. Eur J Vasc Endovasc Surg. 1997 Nov;14(5):386-91.
- Muller L, Bobbia X, Toumi M, Louart G, Molinari N, Ragonnet B, Quintard H, Leone M, Zoric L, Lefrant JY; AzuRea group. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care. 2012 Oct 8;16(5):R188. doi: 10.1186/cc11672.
- Naylor AR, Evans J, Thompson MM, London NJ, Abbott RJ, Cherryman G, Bell PR. Seizures after carotid endarterectomy: hyperperfusion, dysautoregulation or hypertensive encephalopathy? Eur J Vasc Endovasc Surg. 2003 Jul;26(1):39-44.
- Nordlander M, Sjöquist PO, Ericsson H, Rydén L. Pharmacodynamic, pharmacokinetic and clinical effects of clevidipine, an ultrashort-acting calcium antagonist for rapid blood pressure control. Cardiovasc Drug Rev. 2004 Fall;22(3):227-50. Review.
- Robinson TG, James M, Youde J, Panerai R, Potter J. Cardiac baroreceptor sensitivity is impaired after acute stroke. Stroke. 1997 Sep;28(9):1671-6.
- Rothwell PM, Giles MF, Chandratheva A, Marquardt L, Geraghty O, Redgrave JN, Lovelock CE, Binney LE, Bull LM, Cuthbertson FC, Welch SJ, Bosch S, Alexander FC, Silver LE, Gutnikov SA, Mehta Z; Early use of Existing Preventive Strategies for Stroke (EXPRESS) study. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet. 2007 Oct 20;370(9596):1432-42. Erratum in: Lancet. 2008 Feb 2;371(9610):386. Carasco-Alexander, Faye [corrected to Alexander, Faye C].
- Russell DA, Gough MJ. Intracerebral haemorrhage following carotid endarterectomy. Eur J Vasc Endovasc Surg. 2004 Aug;28(2):115-23. Review.
- Singla N, Warltier DC, Gandhi SD, Lumb PD, Sladen RN, Aronson S, Newman MF, Corwin HL; ESCAPE-2 Study Group. Treatment of acute postoperative hypertension in cardiac surgery patients: an efficacy study of clevidipine assessing its postoperative antihypertensive effect in cardiac surgery-2 (ESCAPE-2), a randomized, double-blind, placebo-controlled trial. Anesth Analg. 2008 Jul;107(1):59-67. doi: 10.1213/ane.0b013e3181732e53.
- Stoneham MD, Thompson JP. Arterial pressure management and carotid endarterectomy. Br J Anaesth. 2009 Apr;102(4):442-52. doi: 10.1093/bja/aep012. Epub 2009 Feb 20. Review.
- 2018H0044