Approach to Risk Management of Perioperative Stroke

Sunny S. Chiao , Zhi-Yi Zuo
Department of Anesthesiology, University of Virginia, Charlottesville, Virginia, USA
J Anesth Perioper Med 2015; 2(5): 268- 276 . Published on Aug 28, 2015 . doi:10.24015/JAPM.2015.0036
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Aim of review: Perioperative stroke is a rare, but potentially devastating complication. This review is performed to draw attention of perioperative care providers to this complication and improve their understanding on the risk factors for perioperative stroke so that better management of patients with risk factors can be achieved.

Method: Literature was searched and reviewed to identify articles on risk factors of perioperative stroke and management of these risk factors. 

Recent findings: Stroke rates are as high as 6% after cardiac, neurosurgical, and vascular surgery, and are lower (<1%) after general surgery. Perioperative stroke is mostly ischemic. Risk factors that are not modifiable include increasing age and female gender. Morbidities that increase the risk for perioperative stroke include renal failure, history of stroke or transient ischemic attack, diabetes mellitus, atrial fibrillation, congestive heart failure, smoking status, emergency surgery, carotid stenosis, and valvular cardiac disease. Modifiable factors for perioperative stroke during perioperative period include judicious use of antithrombotic therapy and beta-blockers, avoidance of hypotension and maintenance of normal blood glucose levels. 

Summary: Many risk factors for perioperative stroke have been revealed. Careful management of the modifiable risk factors may reduce the occurrence of perioperative stroke.



Citation: Sunny S. Chiao, Zhi-Yi Zuo. Approach to risk management of perioperative stroke. J Anesth Perioper Med 2015; 2: 268-76. doi: 10.24015/JAPM.2015.0036

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