Carotid endarterectomy and gliofibrillar S100b protein release.
Increased levels of the gliofibrillar S100b protein can be detected during carotid endarterectomy (CEA). Whether the S100b protein increase is marker of brain ischemic sufferance and predictor of cognitive decline is controversial. Twenty-eight patients underwent clinical assessment and cranial computed tomography (CT) 24-48 hours before and 3 months after CEA. S100b serum levels were evaluated before surgery, at cross-clamping, 10 minutes later, at declamping, and 24-48 hours and 10-12 weeks after CEA. Increased S100b levels were detected in 11 patients (39%); eight (73%) of these patients had symptomatic carotid artery disease. Increased S100b level correlated with history of TIA or stroke ( p=0.005), low mini-mental state examination score ( p=0.02), and ischemic infarctions at preoperative CT ( p=0.03). Slight and transient increased S100b levels were detected in 39% of patients during CEA. The protein levels increased despite the absence of clinical events during surgery. Our findings suggest a failure of compensatory hemodynamic or metabolic mechanisms in peri-ischemic tissue, whose longterm effects on cognition remain to be investigated.
Di Legge
S
S
Fifth Unit of Neurology, Department of Neurological Sciences, La Sapienza University, Viale dell'Università 30, I-00185 Rome, Italy.
Di Piero
V
V
Di Stani
F
F
Perna
R
R
Gattuso
R
R
Reale
M G
MG
Benedetti Valentini
F
F
Lenzi
G L
GL
D000222:Adaptation, Physiological / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D020520:Brain Infarction / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D002545:Brain Ischemia / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology; D002339:Carotid Arteries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000601:surgery; D015984:Causality; D002560:Cerebrovascular Circulation / Q000502:physiology; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009414:Nerve Growth Factors / Q000097:blood*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D014057:Tomography, X-Ray Computed; D015854:Up-Regulation / Q000502:physiology
D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human