DIMINISHED PRODUCTION OF MALONDIALDEHYDE AFTER CAROTID-ARTERY SURGERYAS A RESULT OF VITAMIN ADMINISTRATION

The objective of this study was to establish the antioxidative effect of the vitamins E, C and retinyl palmitate (vitamin A), contained in a multivitamin solution, in carotid artery revascularisation surgery. 5 7 patients, 67.84 +/- 5.72 years of age, 39 men and 18 women, were div ided into a control group (27 subjects) and a group with 30 subjects ( mean age 68.46 +/- 5.09 years) who received the vitamin treatment imme diately before the start of reperfusion of the brain. The control grou p (mean age 67.14 +/- 6.37 years) received physiological sodium chlori de as placebo. All of the patients suffered from ischaemic cerebrovasc ular insufficiency manifested as TIA (transitory ischaemic attack) due to haemodynamically significant stenosis of the extracranial part of the ICA (internal carotid artery). Oxidative burst was measured by mal ondialdehyde (MDA) - thiobarbituric acid reactive substances (TBARS) p erioperatively before and 0.5, 1, 2 and 3 h after revascularisation. I n the control group MDA-TBARS significantly increased from 0.91 +/- 0. 49 to 1.15 +/- 0.41 nmol mL(-1) (p < 0.003) 1 h after reperfusion onse t and returned to baseline after 2-3 h. In the vitamin-treated group M DA-TBARS steadily decreased during the reperfusion period (1.11 +/- 0. 39, 0.91 +/- 0.42, 0.81 +/- 0.29, 0.78 +/- 0.39, 0.72 +/- 0.24 nmol mL (-1)). The significant difference in MDA-TBARS between control and tre atment groups, 1 h after the start at reperfusion was 1.15 +/- 0.41 vs 0.81 +/- 0.29 nmol mL(-1); (p < 0.001). As an indirect parameter of r eperfusion injury 13% (4/30 patients) of the patients in the treatment group suffered from headache in contrast to 67% (18/27) in the contro l group. The perioperative use of antihypertensive drugs was 20% (6/30 ) in the treatment group, as compared to 78% (21/27) in the control gr oup. These results suggests that vitamin treatment prior to reperfusio n might be of beneficial effect, alleviating lipid peroxidation and le ading to a better clinical course as regards the central nervous syste m.