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Abstract：
UNASSIGNED: Although aortic aneurysm is associated with vascular aging and atherosclerosis, carotid and intracranial vascular disease prevalence in patients with aortic arch aneurysm remains unclear. Similarly, the effect of carotid and intracranial lesions on postoperative outcomes is unknown. This study aimed to investigate the prevalence of carotid artery stenosis and intracranial lesions in patients with aortic arch aneurysm and its association with intraoperative regional cerebral oxygen saturation (rScO2) and postoperative neurological outcomes, including delirium and cerebral infarction.
UNASSIGNED: This retrospective observational study included 133 patients with true aortic arch aneurysm who underwent preoperative magnetic resonance imaging (MRI). We evaluated the prevalence of carotid and intracranial arterial lesions. Symptomatic cerebral infarction and delirium, defined by the confusion assessment method for the intensive care unit, were evaluated for their association with preoperative cerebrovascular lesions. Additionally, changes in regional saturation of the cerebral tissue at different surgical phases were evaluated for patients with and without cerebrovascular lesions.
UNASSIGNED: Fifteen (11.3%) patients experienced symptomatic cerebral infarction, and 64 (48.1%) had postoperative delirium. Preoperative MRI showed old infarction, microbleeds, significant carotid artery stenosis, and intracranial lesions in 21.1%, 14.3%, 10.5%, and 7.5% of the patients, respectively. White matter hyperintensities with Fazekas scale 2 were observed in 40.6% of the patients, while Fazekas scale 3 were observed in 18.8% of the patients. Preoperative MRI findings and postoperative neurological outcomes were not significantly different. Seventy-six patients underwent rScO2 monitoring intraoperatively. Changes in rScO2 in patients with and without carotid/cerebrovascular lesions were not significantly different. However, rScO2 was significantly lower in patients who developed cerebral infarction.
UNASSIGNED: Significant carotid artery stenosis and intracranial lesions were observed in 10.5% and 7.5% of the patients, respectively. Although preoperative MRI findings and changes in rScO2 or postoperative outcomes showed no significant association, patients with postoperative cerebral infarction showed significantly lower rScO2 intraoperatively.
UNASSIGNED: This retrospective observational study included 133 patients with true aortic arch aneurysm who underwent preoperative magnetic resonance imaging (MRI). We evaluated the prevalence of carotid and intracranial arterial lesions. Symptomatic cerebral infarction and delirium, defined by the confusion assessment method for the intensive care unit, were evaluated for their association with preoperative cerebrovascular lesions. Additionally, changes in regional saturation of the cerebral tissue at different surgical phases were evaluated for patients with and without cerebrovascular lesions.
UNASSIGNED: Fifteen (11.3%) patients experienced symptomatic cerebral infarction, and 64 (48.1%) had postoperative delirium. Preoperative MRI showed old infarction, microbleeds, significant carotid artery stenosis, and intracranial lesions in 21.1%, 14.3%, 10.5%, and 7.5% of the patients, respectively. White matter hyperintensities with Fazekas scale 2 were observed in 40.6% of the patients, while Fazekas scale 3 were observed in 18.8% of the patients. Preoperative MRI findings and postoperative neurological outcomes were not significantly different. Seventy-six patients underwent rScO2 monitoring intraoperatively. Changes in rScO2 in patients with and without carotid/cerebrovascular lesions were not significantly different. However, rScO2 was significantly lower in patients who developed cerebral infarction.
UNASSIGNED: Significant carotid artery stenosis and intracranial lesions were observed in 10.5% and 7.5% of the patients, respectively. Although preoperative MRI findings and changes in rScO2 or postoperative outcomes showed no significant association, patients with postoperative cerebral infarction showed significantly lower rScO2 intraoperatively.
摘要：
■尽管主动脉瘤与血管老化和动脉粥样硬化有关，主动脉弓动脉瘤患者颈动脉和颅内血管疾病的患病率尚不清楚.同样，颈动脉和颅内病变对术后结局的影响尚不清楚.本研究旨在探讨主动脉弓动脉瘤患者颈动脉狭窄和颅内病变的发生率及其与术中局部脑氧饱和度(rScO2)和术后神经系统预后的关系。包括谵妄和脑梗塞。
■这项回顾性观察性研究纳入了133例接受术前磁共振成像（MRI）的真性主动脉弓动脉瘤患者。我们评估了颈动脉和颅内动脉病变的患病率。症状性脑梗死和谵妄，由重症监护病房的混淆评估方法定义，评估了它们与术前脑血管病变的关系。此外,对于有和没有脑血管病变的患者，评估了不同手术阶段脑组织区域饱和度的变化。
■有症状的脑梗塞患者15例(11.3%),64例(48.1%)出现术后谵妄。术前MRI显示陈旧性梗死,微出血，显著的颈动脉狭窄，颅内病变占21.1%，14.3%,10.5%,和7.5%的病人,分别。在40.6%的患者中观察到白质高强度与Fazekas量表2,而在18.8%的患者中观察到Fazekas量表3。术前MRI表现与术后神经系统转归无显著差异。76例患者在术中接受了rScO2监测。有和没有颈动脉/脑血管病变的患者rScO2的变化没有显着差异。然而,发生脑梗死的患者rScO2明显降低。
■在10.5％和7.5％的患者中观察到明显的颈动脉狭窄和颅内病变，分别。尽管术前MRI结果与rScO2或术后结果的变化没有显着相关性，术后脑梗死患者术中rScO2明显降低.
■这项回顾性观察性研究纳入了133例接受术前磁共振成像（MRI）的真性主动脉弓动脉瘤患者。我们评估了颈动脉和颅内动脉病变的患病率。症状性脑梗死和谵妄，由重症监护病房的混淆评估方法定义，评估了它们与术前脑血管病变的关系。此外,对于有和没有脑血管病变的患者，评估了不同手术阶段脑组织区域饱和度的变化。
■有症状的脑梗塞患者15例(11.3%),64例(48.1%)出现术后谵妄。术前MRI显示陈旧性梗死,微出血，显著的颈动脉狭窄，颅内病变占21.1%，14.3%,10.5%,和7.5%的病人,分别。在40.6%的患者中观察到白质高强度与Fazekas量表2,而在18.8%的患者中观察到Fazekas量表3。术前MRI表现与术后神经系统转归无显著差异。76例患者在术中接受了rScO2监测。有和没有颈动脉/脑血管病变的患者rScO2的变化没有显着差异。然而,发生脑梗死的患者rScO2明显降低。
■在10.5％和7.5％的患者中观察到明显的颈动脉狭窄和颅内病变，分别。尽管术前MRI结果与rScO2或术后结果的变化没有显着相关性，术后脑梗死患者术中rScO2明显降低.
