Evidence map›Paper›PMID 33099692›Full record

ArticleActa neurochirurgica2021

Arterial collateral anatomy predicts the risk for intra-operative changes in somatosensory evoked potentials in patients undergoing carotid endarterectomy: a prospective cohort study.

Mandy D Müller, Kathleen Seidel, Giovanni Peschi, Eike Piechowiak, Pascal J Mosimann, Philippe Schucht, Andreas Raabe, David Bervini

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta neurochirurgica, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Mandy D MüllerDepartment of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
Kathleen SeidelDepartment of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
Giovanni PeschiDepartment of Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Eike PiechowiakDepartment of Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Pascal J MosimannDepartment of Neuroradiology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Philippe SchuchtDepartment of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
Andreas RaabeDepartment of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
David BerviniDepartment of Neurosurgery, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland. david.bervini@insel.ch.ORCID http://orcid.org/0000-0003-4873-4452
University of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDuring carotid endarterectomy (CEA), significant amplitude decrement of somatosensory evoked potentials (SEPs) is associated with post-operative neurological deficits.

objectiveTo investigate the association between an incomplete circle of Willis and/or contralateral ICA occlusion and subsequent changes in intra-operatively monitored SEPs.

methodsWe performed a retrospective analysis of a single center, prospective cohort of consecutive patients undergoing CEA over a 42-month period after reviewing the collateral arterial anatomy on pre-operative radiological imaging. The primary endpoint was an intra-operative decline in SEPs > 50% compared to the baseline value during arterial cross-clamping. Univariate and multivariate logistic regression analyses were performed to investigate a potential association between contralateral ICA occlusion, incomplete circle of Willis, and subsequent alteration in SEPs.

resultsA total of 140 consecutive patients were included, of which 116 patients (82.9%) had symptomatic carotid stenosis of at least 50% according to the classification used in the North American Carotid Surgery Trial (NASCET) (Stroke 22:711-720, 1991). Six patients (4.3%) showed contralateral ICA occlusion, 22 patients (16%) a missing/hypoplastic anterior communicating artery (Acom) or A1 segment, and 79 patients (56%) a missing ipsilateral posterior communicating artery (Pcom) or P1 segment. ICA occlusion and missing segments of the anterior circulation (missing A1 and/or missing Acom) were associated with the primary endpoint (p = 0.003 and p = 0.022, respectively).

conclusionContralateral ICA occlusion and missing anterior collaterals of the circle of Willis increase the risk of intra-operative SEP changes during CEA. Pre-operative assessment of collateral arterial anatomy might help identifying patients with an increased intra-operative risk.

Indexed as

AgedCarotid Artery, InternalCircle of WillisCollateral CirculationEndarterectomy, CarotidEvoked Potentials, SomatosensoryFemaleHumansMaleMultivariate AnalysisProspective StudiesRetrospective StudiesRisk FactorsCarotid endarterectomyCerebrovascular diseaseNeuromonitoringRisks assessmentSurgical morbidityVascular anatomy

Identifiers

PMID33099692
PMCPMC8116285
OpenAlexW3093723933

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.