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Licensed Unlicensed Requires Authentication Published by De Gruyter June 1, 2005

Impairment of Blood-Brain Barrier Integrity during Carotid Surgery as Assessed by Serum S-100B Protein Concentrations

Zsuzsanna Járányi , Mária Székely , Ilona Bobek , Ildikó Gálfy , László Gellér and László Selmeci
From the journal

Abstract

During carotid endarterectomy (CEA) the internal carotid artery is cross-clamped for a period of several minutes. This maneuver may cause cerebral hypoperfusion and/or impairment of the blood-brain barrier (BBB) even in cases where clinical signs are absent. The aim of the present study was to examine whether such alterations could be detected by monitoring the cerebral marker S-100B protein concentrations during and after CEA in the serum. Twentyfive consecutive patients (17 M/8 F, mean age: 64.2 years, range 47-79 years) undergoing elective CEA at our department were studied. All of these patients were without perioperative neurological deficit. Intraoperative samples were collected from internal jugular and peripheral venous blood: 1) before carotid cross-clamping; 2) immediately before declamping; 3) after clamp release. Postoperative samples were taken from peripheral blood at 6 and 24 h, respectively. S-100B was assayed in sera using an immunoluminometric technique. During carotid crossclamping, S-100B protein concentrations in the ipsilateral jugular serum significantly (p < 0.02) increased to pre-clamp values. After declamping, however, S-100B returned to the baseline level. No differences were seen between the responses of hypertensive and normotensive patients. There was no correlation between carotid occlusion time and S-100B protein concentrations. In the peripheral venous serum no significant changes in S-100B concentrations were detected during or after CEA. We presume that the elevation of S-100B protein concentration during CEA in patients with no neurological deficits indicates the transient opening of the BBB elicited by carotid cross-clamping. Clin Chem Lab Med 2003; 41(10):13201322

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Published Online: 2005-06-01
Published in Print: 2003-09-19

Copyright © 2003 by Walter de Gruyter GmbH & Co. KG

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