Abstract
BackgroundOur aim was to compare the perioperative time courses of matrix metalloproteinase-9 (MMP-9) and its inhibitor (TIMP-1) in during carotid endarterectomy (CEA) and carotid artery stenting (CAS).MethodsIn our prospective study, twenty-five patients who were scheduled to undergo CAS were enrolled. We used a matched, historical CEA group as controls. Blood samples were collected at four time points: T1: preoperative; T2: 60 min after stent insertion; T3: first postoperative morning; and T4: third postoperative morning. Plasma MMP-9 and TIMP-1 levels were measured by ELISA.ResultsIn the CEA group, the plasma levels of MMP-9 were significantly elevated at T3 compared to T1. In the CAS group, there was no significant difference in MMP-9 levels in the perioperative period. MMP-9 levels were significantly higher in the T3 samples of the CEA group compared to the CAS group. Significantly lower TIMP-1 levels were measured in both groups at T2 than at T1 in both groups. MMP-9/TIMP-1 at T3 was significantly higher than that at T1 in the CEA group compared to both T1 and the CAS group.ConclusionsCAS triggers smaller changes in the MMP-9-TIMP-1 system during the perioperative period, which may correlate with a lower incidence of central nervous system complications. Additional studies as well as cognitive and functional surveys are warranted to determine the clinical relevance of our findings.Trial registrationNIH U.S. National Library of Medicine, Clinicaltrials.gov,NCT03410576, 24.01.2018, Retrospectively registered
Highlights
Our aim was to compare the perioperative time courses of matrix metalloproteinase-9 (MMP-9) and its inhibitor (TIMP-1) in during carotid endarterectomy (CEA) and carotid artery stenting (CAS)
In one of our earlier studies, we examined the time course of CEA-related changes in Matrix metalloproteinases (MMPs)-9 and Tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) [22]
There was no significant difference between the CAS group and the control CEA group in the number of patients enrolled, age, gender, medications, comorbidities and major complications
Summary
Our aim was to compare the perioperative time courses of matrix metalloproteinase-9 (MMP-9) and its inhibitor (TIMP-1) in during carotid endarterectomy (CEA) and carotid artery stenting (CAS). Significant stenosis of the internal carotid artery is a well-known risk factor of ischaemic stroke [3]. The gold standard intervention is carotid endarterectomy (CEA), but carotid artery stenting (CAS) is a less invasive therapeutic method with increasing popularity [4,5,6]. Both methods have well-known complications, clinical trials have found that the risk of death or recurrent stroke within 30 days of surgery in symptomatic patients was higher among the CAS patients than among the CEA patients [7,8,9,10,11,12]. According to the 2014 AHA/ASA stroke prevention guideline for low- or average-risk symptomatic patients, CAS is an alternative to CEA when the internal carotid
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
