Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080



Turkish Journal of Vascular Surgery 2021 , Vol 30 , Issue 3
The psychocognitive, biochemical, and electrophysiological effects of cerebral ischemia-reperfusion injury in patients undergoing carotid endarterectomy accompanied by cervical block
Ergin Arslanoğlu1, Kenan Abdurrahman Kara1, Shiraslan Bakhshaliyev2, Kaan Altunyuva2, Çağla Canbay Sarılar2, Vuslat Yılmaz3, Görkem Şirin3, Nerses Bebek3, İbrahim Ufuk Alpagut2
1Department of Pediatric Cardiovascular Surgery, Koşuyolu High Specialization Education and Research Hospital, Istanbul, Turkey
2Department of Cardiovascular Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
3Department of Neurology and Neuroscience, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
DOI : 10.9739/tjvs.2021.1058 Objectives: This study aims to examine perioperative changes and correlation of electroencephalography (EEG), neuropsychological test (NPT), and neurobiochemical markers in patients undergoing carotid endarterectomy.

Patients and methods: A total of 48 patients (28 males, 20 females; mean age: 68.4±7.7 years; range, 43 to 84 years) who underwent carotid endarterectomy in our clinic between January 2017 and March 2019 were included in the study. Basic activity, slow-wave, and paroxysmal activities were evaluated using the pre- and postoperative EEG. The S100B protein (S100B), neuron-specific enolase (NSE), and glial fibrillary acidic protein (GFAP) values from biochemical markers were studied in all patients in the preoperative period, postoperative early period (Day 2), and postoperative late period. The NPT was examined preoperatively and at one month postoperatively.

Results: The EEG examination of 30 patients revealed a decrease in the slow-wave frequency and amplitude in the EEG of 10 patients without ischemia in the preoperative magnetic resonance imaging examination. The S100B and GFAP values decreased and the NSE values increased statistically significantly in the late postoperative period, although there was no statistically significant difference between the NSE, S100B, and GFAP values in the early postoperative period before and after carotid endarterectomy operation.

Conclusion: The positive effects of carotid endarterectomy on EEG in the patient group without ischemia can be interpreted as the electrophysiological evidence and that possible functional damage associated with carotid stenosis can be improved after endarterectomy. The values of biochemical markers decreased in the late postoperative period with the limitation of inflammation and NSE increased, which may be associated with neuronal regeneration. Keywords : Carotid, carotid stenosis, electroencephalography, endarterectomy

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