Continuous Blood Glucose Monitoring May Detect Carotid Occlusion Intolerance during Carotid Artery Stenting
| Autor: | Naosuke Nonoguchi, Toshihiko Kuroiwa, Hiroyuki Ohnishi, Shinji Kawabata, Ryo Hiramatsu, Ryokichi Yagi, Shigeru Miyachi, Naokado Ikeda, Tomohisa Ohmura, Motomasa Furuse |
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| Rok vydání: | 2017 |
| Předmět: |
Blood Glucose
Male Pancreas Artificial medicine.medical_specialty Time Factors medicine.medical_treatment Pilot Projects 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Angioplasty Monitoring Intraoperative Severity of illness medicine Clinical endpoint Humans Carotid Stenosis Prospective Studies Prospective cohort study Adverse effect Aged Blood glucose monitoring medicine.diagnostic_test business.industry General Medicine Venous blood Treatment Outcome Predictive value of tests Cerebrovascular Circulation Cardiology Surgery Female Stents Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Angioplasty Balloon Biomarkers |
| Zdroj: | Annals of vascular surgery. 49 |
| ISSN: | 1615-5947 |
| Popis: | Background The frequency of the occurrence of adverse events associated with carotid artery stenting (CAS) is usually low, but serious adverse events such as cerebral hyperperfusion syndrome (CHS) may occur. Real-time monitoring is ideal for the early detection of adverse events during the surgical procedure. This study aimed to evaluate continuous blood glucose (BG) monitoring for the detection of adverse events during CAS. Methods Forty patients undergoing scheduled CAS were prospectively enrolled. An artificial pancreas was used for continuous BG monitoring (once per minute), using venous blood extracted at a rate of 2 mL/hr during CAS. The primary endpoint was a correlation between BG change and adverse events. Results CAS was discontinued in 1 patient, and BG was not measured in 5 patients (12.5%) because of the inability to extract blood. Among 34 evaluable patients, no patient developed CHS, but 3 patients (9%) experienced carotid occlusion intolerance. During CAS, BG was significantly higher in patients with carotid occlusion intolerance (median: 5 mg/dL) than in patients without carotid occlusion intolerance (median: 0 mg/dL) (P = 0.0221). A cutoff BG value ≥4 mg/dL during CAS showed 50% sensitivity and 100% specificity for the detection of carotid occlusion intolerance. There was no significant correlation between BG change and other adverse events. Conclusions BG elevation may help detect carotid occlusion intolerance although it is still unknown whether BG monitoring can detect CHS. Further studies should validate that a cutoff BG elevation value of ≥4 mg/dL during CAS indicates carotid occlusion intolerance. |
| Databáze: | OpenAIRE |
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