Abstract Text
Background: Perioperative application of heparine IV during carotid endarterectomy (CEA) is widely used to decrease the risk of perioperative stroke. The aim of the prospective study was to test the effect of perioperative application of heparine IV on the risk of new ischemic lesions detected on control brain magnetic resonance (MR) after CEA. 

Methods: Patients with symptomatic or asymptomatic carotid stenosis ≥70% indicated for CEA, aged 40-85 years, functionally independent, without contraindication to MR were included to the prospective study after signing the informed consent. Neurological examination and brain MR were performed in all patients no more than 24 hours prior to CEA and 24±2 hours after CEA. 

Results: Totally 259 patients (180 males, 79 females, mean age 68.0±8.3 years) were enrolled to the study. New ischemic lesion on control brain MR were detected in 17 out of 128 (13.3%) patients in heparine group and in 17 out of 135 (12.6%) patients in control group (p=0.396). Totally 29 patients were on permanent anticoagulation and Warfarin was replaced by nadroparine at least 2 days prior to CEA in all patients. New ischemic lesion on control brain MR were detected in 9 out of 30 (30%) patients with permanent anticoagulation but only in 23 out of 229 (10%) patients without permanent anticoagulation (p=0.006).

Conclusion: No significant effect of heparine on risk of new ischemic lesions on control brain MR after CEA were detected. Contrary, patients on permanent anticoagulation had significantly higher risk of new ischemic brain lesions. 

Supported by grant MHCR 16-29148A.

Effect of heparine during carotid endarterectomy on risk of new ischemic lesion detected using magnetic resosnance