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  • Title: S-100beta protein levels do not correlate with stroke in patients undergoing carotid endarterectomy under general anesthesia.
    Author: Godet G, Watremez C, Beaudeux JL, Meersschaert K, Koskas F, Coriat P.
    Journal: J Cardiothorac Vasc Anesth; 2001 Feb; 15(1):25-8. PubMed ID: 11254835.
    Abstract:
    OBJECTIVE: To establish the S-100beta protein profile during carotid artery surgery to show a possible correlation between postoperative stroke and this biochemical marker. DESIGN: Prospective, nonrandomized study. SETTING: Departments of anesthesiology, biochemistry, and vascular surgery in a single university hospital. PARTICIPANTS: One hundred patients consecutively scheduled for carotid endarterectomy. MEASUREMENTS AND MAIN RESULTS: Postoperative neurologic complications were defined as major, occurrence of a postoperative permanent stroke, or minor, occurrence of a new postoperative transient ischemic attack lasting < 2 hours. Serum samples were obtained before induction, before carotid artery cross-clamping, after declamping, at the end of surgery, during recovery, and on the first postoperative day. Concentrations of S-100beta were analyzed using a commercially available kit (LIA-mat S300 analyzer, Byk-Sangtec Medical, Bromma, Sweden). Ninety-five patients awoke without a neurologic defect. Three patients experienced a permanent stroke, and 2 patients had a transient ischemic attack. S-100 basal values were unrelated to preoperative status, including hypertension, neurologic status, renal function, and degree of the carotid lesion. S-100 concentration increased slightly but significantly at the end of surgery and remained stable until the first postoperative day. S-100 profile during the procedure was independent of the duration of carotid artery cross-clamping and the need for a shunt. S-100 serum level was not significantly different in the patients with a postoperative ischemic event in comparison with the entire group. The S-100 profile was not increased in 2 of 3 patients with a permanent stroke and in 1 of 2 patients with a transient ischemic attack in comparison with the 95 patients with uneventful recovery. CONCLUSION: S-100 concentration slightly increased at the end of surgery and remained high until the first postoperative day in all patients. S-100 was not significantly different in the patients with postoperative stroke. S-100 did not serve as a marker for postoperative stroke after carotid artery surgery. This fact must be taken into account during further investigations of S-100.
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