{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T18:45:06Z","timestamp":1783968306692,"version":"3.55.0"},"reference-count":70,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T00:00:00Z","timestamp":1734998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the Grant-in-Aid for Scientific Research (KAKENHI)","award":["23KF0126"],"award-info":[{"award-number":["23KF0126"]}]},{"name":"the Grant-in-Aid for Scientific Research (KAKENHI)","award":["P23712"],"award-info":[{"award-number":["P23712"]}]},{"name":"the Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT)","award":["23KF0126"],"award-info":[{"award-number":["23KF0126"]}]},{"name":"the Japan Society for the Promotion of Science (JSPS), Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT)","award":["P23712"],"award-info":[{"award-number":["P23712"]}]},{"name":"the JSPS International Fellowship","award":["23KF0126"],"award-info":[{"award-number":["23KF0126"]}]},{"name":"the JSPS International Fellowship","award":["P23712"],"award-info":[{"award-number":["P23712"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Seizures are a rare but potentially serious complication following carotid endarterectomy (CEA). Understanding their prevalence and associated factors is crucial for optimizing perioperative care and improving patient outcomes. This meta-analysis aimed to estimate the pooled prevalence of seizures following CEA and explore clinical and procedural factors contributing to their occurrence. Methods: We conducted a systematic review and meta-analysis of studies reporting on seizures following CEA. A systematic search of PubMed, Embase, and Cochrane CENTRAL databases was performed, following PRISMA and MOOSE guidelines. Random-effects meta-analysis was used to calculate the pooled prevalence of postoperative seizures. Heterogeneity was assessed using the I2 statistic. A total of 20 studies, encompassing 69,479 patients, were included. Results: The overall pooled prevalence of seizures following CEA was 1% (95% CI: 0\u20132%; p &lt; 0.001), with significant heterogeneity (I2 = 93.52%). Prospective studies reported a higher pooled prevalence (2%, 95% CI 0\u20134%; I2 = 76.34%) compared to retrospective studies (0%, 95% CI 0\u20131%; I2 = 91.51%). Male predominance was noted among patients who experienced seizures, and hypertension was the most common comorbidity. Cerebral hyperperfusion syndrome was identified as a key contributing factor to postoperative seizures. Data on long-term outcomes, including the development of epilepsy, were insufficient for further analysis. The methodological quality of the included studies varied, with most studies demonstrating a moderate risk of bias. Conclusions: Seizures occur in approximately 1% of patients following CEA, with higher rates observed in prospective studies. Cerebral hyperperfusion syndrome is an important contributor to this rare complication. We provide evidence-based specific recommendations for seizure management and introduce the SMART-CEA Checklist, a practical framework to guide perioperative care and reduce complications. Future research should focus on long-term outcomes, including epilepsy, and incorporate standardized methodologies to improve data reliability and guide clinical practice.<\/jats:p>","DOI":"10.3390\/diagnostics15010006","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T09:48:58Z","timestamp":1735033738000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Seizures Following Carotid Endarterectomy: A Comprehensive Meta-Analysis of 69,479 Patients and Evidence-Based Recommendations for Perioperative Care"],"prefix":"10.3390","volume":"15","author":[{"given":"Kruthajn","family":"Rajesh","sequence":"first","affiliation":[{"name":"Global Health Neurology Lab, Sydney, NSW 2150, Australia"},{"name":"UNSW Medicine and Health, University of New South Wales (UNSW), South West Sydney Clinical Campuses, Sydney, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9769-8184","authenticated-orcid":false,"given":"Helen","family":"Shen","sequence":"additional","affiliation":[{"name":"Global Health Neurology Lab, Sydney, NSW 2150, Australia"},{"name":"UNSW Medicine and Health, University of New South Wales (UNSW), South West Sydney Clinical Campuses, Sydney, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9783-3628","authenticated-orcid":false,"given":"Sonu M. M.","family":"Bhaskar","sequence":"additional","affiliation":[{"name":"Global Health Neurology Lab, Sydney, NSW 2150, Australia"},{"name":"UNSW Medicine and Health, University of New South Wales (UNSW), South West Sydney Clinical Campuses, Sydney, NSW 2170, Australia"},{"name":"Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW 2170, Australia"},{"name":"NSW Brain Clot Bank, NSW Health Pathology, Sydney, NSW 2170, Australia"},{"name":"Department of Neurology and Neurophysiology, Liverpool Hospital and South Western Sydney Local Health District (SWSLHD), Sydney, NSW 2170, Australia"},{"name":"National Cerebral and Cardiovascular Center (NCVC), Department of Neurology, Division of Cerebrovascular Medicine and Neurology, Suita 564-8565, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,24]]},"reference":[{"key":"ref_1","first-page":"CD001081","article-title":"Carotid endarterectomy for symptomatic carotid stenosis","volume":"9","author":"Rerkasem","year":"2020","journal-title":"Cochrane Database Syst. 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