Effects of pretreatment with a xanthine oxidase inhibitor on free radical levels during carotid endarterectomy.
OBJECTIVE
Free radicals contribute to the tissue damage caused by ischaemia-reperfusion. The aim of the present study was to investigate whether preoperative antioxidant therapy (allopurinol) affects free radical levels in cerebral venous blood in connection with surgery for carotid artery stenosis.


METHODS
Twenty-five patients were randomised into the study. Thirteen were controls and 12 were pretreated with allopurinol the day before surgery. Before, during and after surgery, blood samples were drawn from the ipsilateral jugular vein. Radical levels were measured using the spin trap technique ex vivo using OXANOH as the spin trap. Multivariate statistics were used with Principal Component Analysis and Partial Least Square regression analysis.


RESULTS
Radical levels increased with diabetes, high leukocyte count, high creatinine and a high degree of contralateral stenosis. Radical levels decreased with high age, blood pressure, collateral circulation as well as operation for left-side carotid artery stenosis. After pretreatment with allopurinol, several of the relationships noted in the control group were eliminated, i.e. leukocyte count, side of operation, Betapred pretreatment and collateral circulation.


CONCLUSIONS
Radical levels can be determined in connection with surgery for carotid artery stenosis using an ex vivo spin trap method. With preoperative antioxidant therapy the relationships between enhanced radical levels and clinical data, as seen in control subjects, disappeared. This might indicate a beneficial effect of preoperative pretreatment with antioxidants.
Waters
Susanna
S
Department of Carlsson Research, P.O.B. 444, S-405 30 Göteborg, Sweden.
Fae
Anita
A
Gondalia
Jagdish
J
Holm
Jan
J
Karlström
Lars
L
Nilsson
Ulf
U
Jonsson
Olof
O
D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000008:administration & dosage*; D000975:Antioxidants / Q000008:administration & dosage*; D016893:Carotid Stenosis / Q000097:blood / Q000601:surgery; D016894:Endarterectomy, Carotid; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005260:Female; D005609:Free Radicals / Q000037:antagonists & inhibitors / Q000097:blood; D006801:Humans; D007601:Jugular Veins / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors*
D000975:Antioxidants; D004791:Enzyme Inhibitors; D005609:Free Radicals; D000493:Allopurinol; D014969:Xanthine Oxidase