S-100beta protein levels do not correlate with stroke in patients undergoing carotid endarterectomy under general anesthesia.
OBJECTIVE
To establish the S-100beta protein profile during carotid artery surgery to show a possible correlation between postoperative stroke and this biochemical marker.


METHODS
Prospective, nonrandomized study.


METHODS
Departments of anesthesiology, biochemistry, and vascular surgery in a single university hospital.


METHODS
One hundred patients consecutively scheduled for carotid endarterectomy.


RESULTS
Postoperative neurologic complications were defined as major, occurrence of a postoperative permanent stroke, or minor, occurrence of a new postoperative transient ischemic attack lasting < 2 hours. Serum samples were obtained before induction, before carotid artery cross-clamping, after declamping, at the end of surgery, during recovery, and on the first postoperative day. Concentrations of S-100beta were analyzed using a commercially available kit (LIA-mat S300 analyzer, Byk-Sangtec Medical, Bromma, Sweden). Ninety-five patients awoke without a neurologic defect. Three patients experienced a permanent stroke, and 2 patients had a transient ischemic attack. S-100 basal values were unrelated to preoperative status, including hypertension, neurologic status, renal function, and degree of the carotid lesion. S-100 concentration increased slightly but significantly at the end of surgery and remained stable until the first postoperative day. S-100 profile during the procedure was independent of the duration of carotid artery cross-clamping and the need for a shunt. S-100 serum level was not significantly different in the patients with a postoperative ischemic event in comparison with the entire group. The S-100 profile was not increased in 2 of 3 patients with a permanent stroke and in 1 of 2 patients with a transient ischemic attack in comparison with the 95 patients with uneventful recovery.


CONCLUSIONS
S-100 concentration slightly increased at the end of surgery and remained high until the first postoperative day in all patients. S-100 was not significantly different in the patients with postoperative stroke. S-100 did not serve as a marker for postoperative stroke after carotid artery surgery. This fact must be taken into account during further investigations of S-100.
Godet
G
G
Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France.
Watremez
C
C
Beaudeux
J L
JL
Meersschaert
K
K
Koskas
F
F
Coriat
P
P
D000368:Aged; D000768:Anesthesia, General; D015415:Biomarkers; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007431:Intraoperative Complications / Q000097:blood* / Q000523:psychology; D008297:Male; D009418:S100 Proteins / Q000097:blood*; D020521:Stroke / Q000097:blood* / Q000523:psychology
D015415:Biomarkers; D009418:S100 Proteins