Neurologic deficits following noncarotid vascular surgery

E. John Harris, Gregory (Greg) Moneta, Richard A. Yeager, Lloyd M. Taylor, John M. Porter

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Neurologic events following noncarotid vascular surgery (NCVS) are considered unpredictable. To test this hypothesis, we reviewed our vascular registry for a 3-year period and identified all patients with new postoperative focal neurologic events (stroke, hemispheric transient ischemic attack [TIA]) within 2 weeks of a category I or II vascular procedure as defined by the American Board of Surgery, exclusive of carotid surgery and arterial trauma. Thirteen of 1,390 NCVS procedures (0.9%) in 13 patients were associated with focal neurologic events. There were 2 TIAs, 10 anterior circulation strokes, and 1 posterior circulation stroke. Twentyseven percent of strokes were fatal. The neurologic deficit developed in the immediate postoperative period in 31%, more than 4 hours but less than 72 hours postoperatively in 54%, and within 3 to 14 days postoperatively in 15%. Patients with anterior circulation events (group A, n = 12) were compared for variables potentially influencing postoperative stroke with case controls who were selected using a table of random numbers (group B, n = 12). Controls were derived from a pool of all category I or II NCVS procedures recorded in our vascular registry sequentially during the same time period and who were without new neurologic deficits postoperatively. Using Fisher's exact test, comparisons between groups A and B revealed that new anterior circulation neurologic events in vascular surgical patients tended to be associated with intra-abdominal procedures (p <0.05), perioperative hypotension (p <0.05), and the presence of a greater than or equal to 50% internal carotid artery stenosis ipsilateral to the neurologic event (p <0.001). Such information may prove useful in the management of selected patients prior to arterial reconstruction and in operated NCVS patients with postoperative neurologic events.

Original languageEnglish (US)
Pages (from-to)537-540
Number of pages4
JournalThe American Journal of Surgery
Volume163
Issue number5
DOIs
StatePublished - 1992
Externally publishedYes

Fingerprint

Neurologic Manifestations
Blood Vessels
Nervous System
Stroke
Registries
Carotid Stenosis
Transient Ischemic Attack
Postoperative Period
Hypotension
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Neurologic deficits following noncarotid vascular surgery. / Harris, E. John; Moneta, Gregory (Greg); Yeager, Richard A.; Taylor, Lloyd M.; Porter, John M.

In: The American Journal of Surgery, Vol. 163, No. 5, 1992, p. 537-540.

Research output: Contribution to journalArticle

Harris, E. John ; Moneta, Gregory (Greg) ; Yeager, Richard A. ; Taylor, Lloyd M. ; Porter, John M. / Neurologic deficits following noncarotid vascular surgery. In: The American Journal of Surgery. 1992 ; Vol. 163, No. 5. pp. 537-540.
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