Biomarkers of brain ischemia-reperfusion injury after carotid endarterectomy

Introduction: Endarterectomy of the internal carotid artery (CEA) is a surgical procedure used to prevent cerebral ischemic stroke. Available data from previous literature indicates that CEA may lead to complications in the form of cerebral ischemia-reperfusion syndrome and oxidative stress. The aim of this study was to evaluate the serum levels of oxidative stress-related biomarkers such as 8-hydroxydeoxyguanosine (8-OHdG) and malondialdehyde (MDA) in patients who underwent CEA. Material and methods: Twenty-four patients with severe internal carotid artery stenosis participated in the study. Serum samples were taken from patients at three different times: within 24 hours preoperatively to CEA, 12 hours postoperatively, and 48 hours postoperatively. Serum 8-OHdG and MDA levels were measured using a commercially available enzyme-linked immunosorbent assay. Results: Serum 8-OHdG levels indicated statistically significant elevation 12 hours after surgery when compared to preoperative levels (p < 0.05). A further increase in the concentration of this parameter was observed 48 hours after surgery when compared to the previous measurement, however, this increase was no longer statistically significant (p = 0.05). Furthermore, serum MDA levels also indicated a statistically significant elevation 48 hours after surgery when compared to preoperative levels (p < 0.05). Conclusion: Our study showed that CEA causes an increase in blood levels of 8-OHdG and MDA, which may be related to the occurrence of oxidative stress during cerebral ischemia-reperfusion injury. Therefore, 8-OHdG and MDA may represent corresponding markers of cerebral ischemia-reperfusion complications in patients undergoing CEA.