scholarly journals Intraoperative Monitoring for Carotid Endarterectomy Using Regional Saturation of Oxygen, Motor Evoked Potential and Somatosensory Evoked Potential: Reference to Necessity of Internal Shunt

2014 ◽  
Vol 42 (5) ◽  
pp. 340-346
Author(s):  
Shinya KOYAMA ◽  
Masashi CHONAN ◽  
Kuniyasu NIIZUMA ◽  
Hiroyuki KON ◽  
Makoto ABE ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Intraoperative Monitoring ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Somatosensory Evoked Potential ◽  
Regional Saturation Of Oxygen

Outcomes of Combined Somatosensory Evoked Potential, Motor Evoked Potential, and Electroencephalography Monitoring during Carotid Endarterectomy

2014 ◽  
Vol 28 (3) ◽  
pp. 665-672 ◽  
Author(s):  
Sean D. Alcantara ◽  
Joseph C. Wuamett ◽  
John C. Lantis ◽  
Sedat Ulkatan ◽  
Philip Bamberger ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Somatosensory Evoked Potential

Intraoperative motor and somatosensory evoked potential monitoring during surgical clipping of ruptured and unruptured intracranial aneurysms: a comparative study

2021 ◽  
pp. 1-8
Author(s):  
Hao You ◽  
Xing Fan ◽  
Jiajia Liu ◽  
Dongze Guo ◽  
Zhibao Li ◽  
...  
Keyword(s):  
Evoked Potential ◽  
Motor Evoked Potential ◽  
Critical Values ◽  
Somatosensory Evoked Potential ◽  
Short Term ◽  
Surgical Clipping ◽  
Unruptured Aneurysms ◽  
Ruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms

OBJECTIVE The current study investigated the correlation between intraoperative motor evoked potential (MEP) and somatosensory evoked potential (SSEP) monitoring and both short-term and long-term motor outcomes in aneurysm patients treated with surgical clipping. Moreover, the authors provide a relatively optimal neurophysiological predictor of postoperative motor deficits (PMDs) in patients with ruptured and unruptured aneurysms. METHODS A total of 1017 patients (216 with ruptured aneurysms and 801 with unruptured aneurysms) were included. Patient demographic characteristics, clinical features, intraoperative monitoring data, and follow-up data were retrospectively reviewed. The efficacy of using changes in MEP/SSEP to predict PMDs was assessed using binary logistic regression analysis. Subsequently, receiver operating characteristic curve analysis was performed to determine the optimal critical value for duration of MEP/SSEP deterioration. RESULTS Both intraoperative MEP and SSEP monitoring were significantly effective for predicting short-term (p < 0.001 for both) and long-term (p < 0.001 for both) PMDs in aneurysm patients. The critical values for predicting short-term PMDs were amplitude decrease rates of 57.30% for MEP (p < 0.001 and area under the curve [AUC] 0.732) and 64.10% for SSEP (p < 0.001 and AUC 0.653). In patients with an unruptured aneurysm, the optimal critical values for predicting short-term PMDs were durations of deterioration of 17 minutes for MEP (p < 0.001 and AUC 0.768) and 21 minutes for SSEP (p < 0.001 and AUC 0.843). In patients with a ruptured aneurysm, the optimal critical values for predicting short-term PMDs were durations of deterioration of 12.5 minutes for MEP (p = 0.028 and AUC 0.706) and 11 minutes for SSEP (p = 0.043 and AUC 0.813). CONCLUSIONS The authors found that both intraoperative MEP and SSEP monitoring are useful for predicting short-term and long-term PMDs in patients with unruptured and ruptured aneurysms. The optimal intraoperative neuromonitoring method for predicting PMDs varies depending on whether the aneurysm has ruptured or not.

Intraoperative monitoring of motor-evoked potential for parenchymal brain tumor removal: An analysis of false-negative cases

2018 ◽  
Vol 57 ◽  
pp. 105-110
Author(s):  
Takeru Umemura ◽  
Shigeru Nishizawa ◽  
Yoshiteru Nakano ◽  
Takeshi Saito ◽  
Takehiro Kitagawa ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Intraoperative Monitoring ◽  
Evoked Potential ◽  
False Negative ◽  
Motor Evoked Potential ◽  
Tumor Removal

Somatosensory Evoked Potential and Transcranial Doppler Monitoring to Guide Shunting in Carotid Endarterectomy

2020 ◽  
Author(s):  
Kathleen Seidel ◽  
Johannes Jeschko ◽  
Philippe Schucht ◽  
David Bervini ◽  
Christian Fung ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Flow Velocity ◽  
Transcranial Doppler ◽  
Death Rate ◽  
Evoked Potential ◽  
Somatosensory Evoked Potential ◽  
End Point ◽  
Neurologic Deficits ◽  
Ica Stenosis ◽  
Sep Monitoring

Abstract Objective Clamping of the internal carotid artery (ICA) during carotid endarterectomy (CEA) is a critical step. In our neurosurgical department, CEAs are performed with transcranial Doppler (TCD) and somatosensory evoked potential (SEP) monitoring with a 50% flow velocity/amplitude decrement warning criteria for shunting. The aim of our study was to evaluate our protocol with immediate neurologic deficits after surgery for the primary end point. Methods This is a single-center retrospective cohort study of symptomatic and asymptomatic ICA stenosis patients from January 2012 to June 2015. Only those cases in which CEA was performed with both modalities (TCD and SEP) were included. The Mann-Whitney U test was applied to evaluate TCD and SEP ratios based on immediate postoperative neurologic deficits. Results A total of 144 patients were included, 120 (83.3%) with symptomatic ICA stenosis. The primary end point was met by six patients (4.2%); all of them were patients with a symptomatic ICA stenosis. The stroke and death rate was 1.4%. Ratios of SEP amplitudes demonstrated significant differences between patients with and without an immediate postoperative neurologic deficit at the time of ICA clamping (p = 0.005), ICA clamping at 10 minutes (p = 0.044), and ICA reperfusion (p = 0.005). Ratios of TCD flow velocity showed no significant difference at all critical steps. Conclusion In this retrospective series of simultaneous TCD and SEP monitoring during CEA surgery of predominantly symptomatic ICA stenosis patients, the stroke and death rate was 1.4%. SEP seemed to be superior to TCD in predicting the need for an intraoperative shunt and for predicting temporary postoperative deficits. Further prospective studies are needed.

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