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Dextran reduces embolic signals after carotid endarterectomy

Authors

  • Christopher R. Levi MBBS, FRACP,

    1. Department of Neurology, John Hunter Hospital, Newcastle
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  • Jacinda L. Stork BA, BAppSci (Hons),

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Brian R. Chambers MD, FRACP,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Anne L. Abbott MBBS, FRACP,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Heather M. Cameron RN,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Anna Peeters BSc (Hons), PhD,

    1. Department of Epidemiology and Preventative Medicine, Monash University, Melbourne
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  • John P. Royle FRACS, FACS,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Andrew K. Roberts FRACS, FACS,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Gary Fell MBBS, FRACS,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Michael C. Hoare MBBS, FRACS,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Anthony T. W. Chan Mmed (Surg), FRACS,

    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
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  • Geoffrey A. Donnan MD, FRACP

    Corresponding author
    1. National Stroke Research Institute and Departments of Neurology and Vascular Surgery, Austin and Repatriation Medical Center, Melbourne, Australia
    • National Stroke Research Institute, Neurosciences Building, Repatriation Campus, Austin and Repatriation Medical Centre, Heidelberg West, Victoria 3081, Australia
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Abstract

One hundred fifty patients undergoing carotid endarterectomy were randomly assigned to receive intravenous 10% dextran 40 or placebo. Transcranial Doppler monitoring of the ipsilateral middle cerebral artery 0 to 1 hour postoperatively detected embolic signals in 57% of placebo and 42% of dextran patients, with overall embolic signal counts 46% less for dextran (p = 0.052). Two to 3 hours postoperatively, embolic signals were present in 45% of placebo and 27% of dextran patients, with embolic signal counts 64% less for dextran (p = 0.040). We conclude that dextran reduces embolic signals within 3 hours of CEA.

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