Abstract 4145483: Comparison of Micro Embolic Signals During Carotid Procedures in Patients With Diabetes Mellitus and Patients Without Diabetes Mellitus

Introduction: The rate and significance of micro embolic events during carotid endarterectomy (CEA) and carotid artery stenting (CAS) remains unclear. We evaluated pre-procedural, intra-procedural, and post-procedural micro embolic signal (MES) rates in patients treated electively with CEA and transfemoral CAS with distal filter protection monitoring MES continuously with transcranial Doppler (TCD). The aims of the study were to determine if patients with diabetes mellitus (DM) had more MES than patients without DM during the procedures and if there were significant effects of the revascularizations on cognitive functions in the short term. Methods: Fifty-six patients (mean age 71±9 years; 35 male, 21 female) with significant carotid stenosis underwent successful TCD monitoring during the elective revascularization procedures [34 (61%) CEAs and 22 (39%) CASs]. 22 (39%) had DM when they were enrolled into the study. Ipsilateral MES were segregated into a total of 9 phases of pre-procedure, intra-procedure and post-procedure and the data were analyzed with IBM SPSS software. Cognitive functions were assessed with Mini Mental State Examination 2nd Edition questionnaire. The cognitive tests were administered within 1 day before and after the treatment. Results: There were no statistically significant differences in the MES rates in any stage of the procedures between the patients with DM and the patients without DM. There were also no differences in the Mini-Mental State Examination scores before and after the procedures between patients with DM and patients without DM. Conclusion: TCD recordings did not demonstrate any significant differences of MES rates during all phases of the carotid procedures between patients with DM and patients without DM. Interestingly, no difference was also found in cognitive function in pre and post procedure periods in both groups.