Dextran Increases Risks After Carotid Endarterectomy
Study by NYMC Researchers Shows Dextran Increased Odds of Major Adverse Cardiac Events and Failed to Decrease Risk of Stroke
Dextran, a medication used during carotid endarterectomy (CEA) to mitigate the risk of embolism, was found to increase the risks of major adverse cardiac events without decreasing the risk of stroke, in a new study published by New York Medical College students and faculty in the Annals of Vascular Surgery. The retrospective analysis examined the records of more than 140,000 patients who underwent CEA from 2008 to 2022.
“Several studies have shown the potential efficacy of dextran therapy to reduce an embolic risk in patients undergoing CEA. Yet dextran has been associated with adverse reactions, including anaphylaxis, hemorrhage, cardiac and renal complications,” said Jessica McQuaid Moore, M.S., SOM Class of 2025, who served as lead author of the study.
Additional researchers on the study included: Igor Laskowski, M.D., Ph.D., associate professor of surgery; Romeo Mateo, M.D., assistant professor of surgery; Sateesh Babu, M.D., professor of surgery; Arun Goyal, M.D., clinical assistant professor of surgery; Daniel Ventarola, M.D., clinical assistant professor of surgery; and Heepeel Chang, M.D., clinical assistant professor of surgery.
The researchers found the intraoperative infusion of dextran in patients undergoing CEA was associated with increased odds of major adverse cardiac events, including myocardial infarction, congestive heart failure and hemodynamic instability requiring vasoactive agents, without decreasing the risk of stroke.
“These results suggest judicious use of dextran in patients undergoing CEA,” said Moore, who presented the study at the Vascular and Endovascular Surgery Society Annual Meeting in Whistler, Canada in January. “Furthermore, careful perioperative cardiac management is warranted in select patients receiving dextran.”