Oxidative injury associated with stenting of asymptomatic carotid artery stenosis

• Published in: VASA Vol. 46; no. 4; p. 268
• Main Authors: Saraçoğlu, Erhan, Vuruşkan, Ertan, Çekici, Yusuf, Kiliç, Salih, Ay, Halil, Ergün, Uğur
• Format: Journal Article
• Language: English
• Published: Switzerland 01.07.2017
• Subjects: Aged; Antioxidants - metabolism; Asymptomatic Diseases; Biomarkers - blood; Carotid Stenosis - diagnosis; Carotid Stenosis - therapy; Cerebrovascular Disorders - blood; Cerebrovascular Disorders - diagnosis; Cerebrovascular Disorders - etiology; Disability Evaluation; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Oxidative Stress; Risk Factors; Stents; Sulfhydryl Compounds - blood; Time Factors; Treatment Outcome; carotid artery stenting; oxidative damage; total thiol; Reperfusion injury
• ISSN: 0301-1526
• DOI: 10.1024/0301-1526/a000621

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 findings following CAS in patients with asymptomatic carotid artery stenosis. We included 131 neurologically asymptomatic patients requiring CAS. The neurological findings were evaluated using the modified 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. 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). We demonstrate a possible correlation between oxidative damage and neurological findings after CAS which could not be explained by routine imaging methods.