Abstract
The relationship between early hypertension following carotid endarterectomy, and intraoperative cerebral ischemia was investigated. Two measures of the adequacy of collateral cerebral circulation during carotid clamping were used: collateral cerebral perfusion pressure (ΔAP), and the ratio of collateral to Ipsilateral cerebral vascular resistance (R/R). Change in blood pressure was measured by the ratio of mean early post to preendarterectomy pressure (P/P). Nitroprusside or nitroglycerin (NN) was used after endarterectomy to maintain systolic blood pressure <160 mmHg. The mean values for NN (n=26) and no NN (n=81) groups were: ΔP=30.0 and 40.2 mmHg (p<0.001); R/R=1.93 and 1.24 (p<0.005); and P/P=1.03 and 0.857 (p<0.001 p by unpairedt test). Linear regression analysis of the two measures of cerebral perfusion with the ratio of post-to preoperative blood pressure gave correlation coefficients between 0.629 and 0.841 with a probability that the slope of the regression line >0 of <0.01. Low ΔP and high R/R correlate with early postcarotid endarterectomy hypertension. These results support the hypothesis that one determinant of early post endarterectomy hypertension is Inadequate collateral cerebral circulation during carotid clamping.
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Archie, J.P. The relationship of early hypertension folio wing carotid endarterectomy to intraoperative cerebral ischemia. Annals of Vascular Surgery 2, 108–113 (1988). https://doi.org/10.1007/BF03187559
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DOI: https://doi.org/10.1007/BF03187559