scholarly journals VESS03. Evaluating the Efficacy of Selective Shunting and Cerebral Monitoring During Carotid Endarterectomy Using the VQI Database

2016 ◽  
Vol 63 (6) ◽  
pp. 5S-6S
Author(s):  
Clay P. Wiske ◽  
Isibor Arhuidese ◽  
Mahmoud B. Malas ◽  
Robert B. Patterson
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Monitoring

Cerebral oximetry and stump pressure as indicators for shunting during carotid endarterectomy: comparative evaluation

Vascular ◽  
2011 ◽  
Vol 19 (4) ◽  
pp. 187-194 ◽  
Author(s):  
Charalambos L Tambakis ◽  
George Papadopoulos ◽  
Theodoros N Sergentanis ◽  
Nikolaos Lagos ◽  
Eleni Arnaoutoglou ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Operating Characteristic ◽  
Internal Carotid ◽  
Cerebral Oxygenation ◽  
Cerebral Oximetry ◽  
Characteristic Analysis ◽  
Shunt Insertion ◽  
Stump Pressure ◽  
Baseline Recording ◽  
Cerebral Monitoring

The purpose of this work is to investigate the correlation between regional oxygen saturation (rSO2) changes and stump pressure (SP) during cross-clamping of the internal carotid artery in carotid endarterectomy (CEA) and verify the perspectives of rSO2 to become a criterion for shunting. Sixty consecutive CEAs under general anesthesia were studied prospectively. Selective shunting was based on SP ≤40 mmHg exclusively. Regression analysis with high order terms and receiver operating characteristic analysis were performed to investigate the association between ΔrSO2(%) and SP and to determine an optimal ΔrSO2(%) threshold for shunt insertion. A quadratic association between ΔrSO2(%) and SP was documented regarding the baseline to one and five minutes after cross-clamping intervals. A cut-off of 21 and 10.1% reduction from the baseline recording was identified as optimal for the distinction between patients needed or not a shunt regarding the first and fifth minute after cross-clamping, respectively. In conclusion, cerebral oximety reflects sufficiently cerebral oxygenation during CEA compared with SP, providing a useful mean for cerebral monitoring.

scholarly journals Cerebral monitoring during carotid endarterectomy using transcranial cerebral oximetry

2020 ◽  
Vol 121 (06) ◽  
pp. 431-436
Author(s):  
V. Sihotsky ◽  
P. Berek ◽  
I. Kopolovets ◽  
M. Frankovicova ◽  
P. Stefanic ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Oximetry ◽  
Cerebral Monitoring

Noninvasive cerebral oximetry during carotid endarterectomy: application and results

2015 ◽  
Vol 22 (2) ◽  
pp. 55-60
Author(s):  
Eglė Kontrimavičiūtė ◽  
Vilma Kuzminskaitė ◽  
Jūratė Šipylaitė
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Oxygenation ◽  
Brain Perfusion ◽  
University Hospital ◽  
Cerebral Oximetry ◽  
Neurologic Outcomes ◽  
Study Results ◽  
The Difference ◽  
Cerebral Monitoring ◽  
And Control

Background. Cerebral monitoring during carotid endarterectomy allows to detect brain hypoperfusion following carotid clamping and hyperperfusion after restoring the blood flow. Immediate corrections of these changes have the potential in reducing adverse neurologic outcomes. In this study we share our experience using cerebral oximetry in carotid endarterectomy surgery, as well as finding a connection between comorbidities and baseline cerebral oxygenation values. Materials and methods. A non-randomised perspective study was performed at Vilnius University Hospital Santariškių Clinics. During 2012–2013 all consecutive elective patients undergoing carotid surgery were enrolled in the study. Results. No difference was found in the baseline values on the operative and control sides (71.15% vs 76.76%, p = 0.15). After carotid clamping regional brain saturation decreased by 4.34% of the baseline on the operative side. During the clamping cerebral oxygenation was lower on the operative side (68.06% vs 77.32%, p = 0.03). Following carotid declamping the difference between operative and control side oxygenation diminished (73.57% vs 79.30%, p = 0.16). Neither diabetes nor peripheral atherosclerosis had influence on baseline cerebral oxygen saturation values. There was a tendency towards the lower cerebral oxygenation baseline for smokers (70.12% vs 76.54%, p = 0.103). Conclusions. Cerebral oximetry is a valuable method of cerebral monitoring reflecting changes in brain perfusion during carotid endarterectomy. Certain comorbidities might have a role in affecting baseline oximetry values.

scholarly journals Cerebral monitoring in patients undergoing carotid endarterectomy using a triple assessment technique

2010 ◽  
Vol 12 (3) ◽  
pp. 454-457 ◽  
Author(s):  
A. M. Ali ◽  
D. Green ◽  
H. Zayed ◽  
M. Halawa ◽  
K. El-sakka ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Assessment Technique ◽  
Triple Assessment ◽  
Cerebral Monitoring

scholarly journals Carotid Endarterectomy Without Indwelling Shunts and Intraoperative Electrophysiologic Monitoring

1987 ◽  
Vol 14 (2) ◽  
pp. 131-135 ◽  
Author(s):  
Kesava Reddy ◽  
Michael West ◽  
Brian Anderson
Keyword(s):  
North America ◽  
Mortality Rate ◽  
Prospective Study ◽  
Carotid Endarterectomy ◽  
Surgical Procedure ◽  
Eeg Monitoring ◽  
Satisfactory Outcome ◽  
A Prospective Study ◽  
Cerebral Monitoring

Abstract:Although carotid endarterectomy is a common surgical procedure in North America, controversies exist regarding the type of anesthesia, the use of indwelling shunts and the need for intraoperative cerebral monitoring. We present a prospective study of 100 carotid endarterectomies performed over a three year period by a single surgeon without the use of indwelling shunts, patch grafts, or EEG monitoring. The combined stroke and mortality rate was 1%. Our results confirm those of other authors; that indwelling shunts and EEG monitoring are not absolutely essential for a satisfactory outcome in carotid endarterectomies.

scholarly journals Optimal cerebral monitoring during carotid endarterectomy: Neurologic response under local anesthesia

1985 ◽  
Vol 2 (6) ◽  
pp. 775-777 ◽  
Author(s):  
William E. Evans ◽  
James P. Hayes ◽  
Eugene A. Waltke ◽  
Blair D. Vermilion
Keyword(s):  
Carotid Endarterectomy ◽  
Local Anesthesia ◽  
Cerebral Monitoring

The potential benefits and the role of cerebral monitoring in carotid endarterectomy

2011 ◽  
Vol 24 (6) ◽  
pp. 693-697 ◽  
Author(s):  
Claire W.A. Pennekamp ◽  
Frans L. Moll ◽  
Gert Jan de Borst
Keyword(s):  
Carotid Endarterectomy ◽  
Potential Benefits ◽  
Cerebral Monitoring
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