The impact of carotid artery cross-clamp duration on postoperative hypertension following endarterectomy

Abstract

Aim: The incidence of carotid artery stenosis is increasing globally with an aging population. Carotid endarterectomy is a surgical treatment for severe carotid stenosis. However, hypertension, which frequently develops after carotid endarterectomy, significantly increases postoperative morbidity and mortality. While various causes of post-endarterectomy hypertension have been proposed, the exact mechanism remains unclear. This study aims to investigate whether the duration of carotid clamping influences the development of post-endarterectomy hypertension. Materials and methods: 80 patients who underwent carotid endarterectomy between 2022 and 2024 were included in the study. Eight patients were women (10%), and 72 were men (90%). Their average age was 70.83. The average carotid artery clamp time during the operations was 13.8 minutes. Arterial hypertension values were measured and recorded 1 hour before and 1 hour after the surgery. The relationship between the cross-clamp duration applied to the internal, common, and external carotid arteries during carotid endarterectomy and the subsequent postoperative hypertension values was examined. Results: In this study involving 80 patients who underwent carotid endarterectomy, a statistically significant relationship was found between the cross-clamp duration applied to the carotid artery and postoperative hypertension. Significant increases were observed in systolic and diastolic blood pressure values with the cross-clamp duration (p<0.001). Discussion: The prolongation of cross-clamp time during carotid endarterectomy is associated with an increased degree of hypertension observed postoperatively. These findings suggest that efforts to minimize cross-clamp times could reduce the risk of hypertension and improve patient outcomes. Future studies should investigate the effects of different surgical techniques and patient management protocols on hypertension, providing additional data to prevent this complication.