The Role of Serum Biomarkers in the Prediction of Immediate Postoperative Complications after Carotid Endarterectomy
Categoria dell'articolo: Original Research
Pubblicato online: 28 mar 2025
Pagine: 26 - 35
Ricevuto: 17 dic 2024
Accettato: 11 feb 2025
DOI: https://doi.org/10.2478/jce-2025-0002
Parole chiave
© 2025 Ioan Alexandru Balmos et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 3.0 Public License.
Background
Severe carotid stenosis is a significant cause of stroke and transient ischemic attack. The most common surgical treatment of this pathology aimed at reducing neurological complications is carotid endarterectomy (CEA), a procedure associated with a low rate of postoperative complications and improved quality of life. The aim of this study was to identify serum biomarkers that can predict immediate postoperative complications following CEA.
Methods
This prospective study was conducted over 1 year at the Department of Vascular Surgery of the County Emergency Clinical Hospital of Târgu Mureș, Romania. A total of 46 patients with severe carotid stenosis who underwent CEA were included in the study. Blood samples were collected before surgery to determine the levels of serum biomarkers, and the patients were monitored postoperatively for the first 48 h to identify immediate complications.
Results
We found a predominance of male patients in our study population, with hypertension, dyslipidemia, and ischemic heart disease being the most common comorbidities. After CEA, the observed complications included stroke, transient ischemic attack, cranial nerve palsy, neck hematoma, and severe hypotension. Statistical analyses were conducted to assess potential correlations between serum biomarker levels and these complications. Elevated preoperative levels of high-sensitivity C-reactive protein and matrix metalloproteinase-9 were associated with an increased risk of immediate postoperative complications during hospitalization. In contrast, high levels of monocyte chemoattractant protein-1 and oxidized low-density lipoprotein did not show a significant correlation with acute complications after CEA.
Conclusions
This study highlights that CEA is a safe procedure with few acute postoperative complications. When such complications do occur, they are correlated with elevated preoperative levels of high-sensitivity C-reactive protein and matrix metal-loproteinase-9.