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Journal of Cardiothoracic Surgery

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01-12-2020 | Stroke | Research

The use of cIMT as a predictor of postoperative stroke in patients undergoing surgical repair of acute type a aortic dissection

Authors: Kai Zhang, Si-Chong Qian, Xu-Dong Pan, Song-Bo Dong, Jun Zheng, Hong Liu, Yue-Li Wang, Li-Zhong Sun

Published in: Journal of Cardiothoracic Surgery | Issue 1/2020

Abstract

Background

Acute type A aortic dissection (ATAAD) is a life-threatening condition that requires surgical intervention. Stroke remains an extremely serious adverse outcome that can occur in ATAAD patients undergoing aortic arch repair, leading to higher rates of patient mortality and decreased postoperative quality of life. In the present study, we sought to determine whether carotid intima–media thickness (cIMT) is a reliable predictor of postoperative stroke risk.

Materials and methods

This was a prospective study of 76 patients with ATAAD undergoing aortic arch repair. For all patients, cIMT was determined preoperatively through a Doppler-based method. Incidence of different forms of neurological dysfunction, including temporary neurological dysfunction (TND) and stroke, was monitored in these patients, and the relationship between cIMT and stroke incidence was assessed using a receiver-operating characteristic (ROC) curve. Prognostic variables associated with stroke risk were further identified through univariate and multivariate analyses.

Results

A total of 26/76 (34.2%) patients in the present study suffered from neurological dysfunction, of whom 16 (21.0%) suffered from TND and 10 (13.2%) suffered a stroke. The remaining 50 patients (65.8%) did not suffer from neurological dysfunction. The cIMT values in the stroke, TND, and neurological dysfunction-free patients in this study were 1.12 ± 0.19 (mm), 0.99 ± 0.13 (mm), and 0.87 ± 0.13 (mm), respectively. A total of 4 patients in this cohort died during the study, including 1 in the TND group and 3 in the stroke group. An ROC curve analysis indicated that cIMT could predict stroke with an area under the curve value of 0.844 (95% CI, 0.719–0.969; p < 0.001). A multivariate analysis revealed that cIMT > 0.9 mm was independently associated with stroke risk (p = 0.018).

Conclusion

We found that cIMT can be used to predict postoperative stroke risk in ATAAD patients undergoing aortic arch repair, with a cIMT > 0.9 mm coinciding with increased stroke risk in these patients.

Trial registration

ChiCTR1900022289. Date of registration 4 April 2019 retrospectively registered.

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Title: The use of cIMT as a predictor of postoperative stroke in patients undergoing surgical repair of acute type a aortic dissection
Authors: Kai Zhang
Si-Chong Qian
Xu-Dong Pan
Song-Bo Dong
Jun Zheng
Hong Liu
Yue-Li Wang
Li-Zhong Sun
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Stroke
Circulatory Arrest
Aortic Dissection
Published in: Journal of Cardiothoracic Surgery / Issue 1/2020
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-020-01100-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The use of cIMT as a predictor of postoperative stroke in patients undergoing surgical repair of acute type a aortic dissection

Abstract

Background

Materials and methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Trial registration

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