Brain injury due ischemia and reperfusion in carotid endarterectomy surgery

Abstract Some authors have suggested that carotid endarterectomy could cause brain injury related to ischemia and reperfusion episodes and to postoperative hyperperfusion syndrome. Several mechanisms, such as free fatty acid and urine metabolites, nitric oxide formation, and leukocyte action, would be involved in the production of these alterations. Brain tissue injury due to ischemia and reperfusion has been demonstrated in clinical and experimental studies. Experimental studies have also studied the pathophysiology of the brain injuries and sought adequate treatment. Therefore, these studies are useful and important, but the great variety of experimental models used and the diversity of results achieved reflect the need for a simple, reproducible and consistent model for brain ischemia and reperfusion in order to test treatments that can minimize the damage caused by this kind of surgical intervention.