Cerebral protection from ischaemia during carotid endarterectomy

2020 ◽  
Vol 26 (1) ◽  
pp. 96
Author(s):  
A. N. Vachev ◽  
M. G. Prozhoga ◽  
O. V. Dmitriev
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Protection

Routine Shunting Is a Safe and Reliable Method of Cerebral Protection during Carotid Endarterectomy

2006 ◽  
Vol 20 (4) ◽  
pp. 482-487 ◽  
Author(s):  
Raffaello Bellosta ◽  
Luca Luzzani ◽  
Claudia Carugati ◽  
Matteo Talarico ◽  
Antonio Sarcina
Keyword(s):  
Carotid Endarterectomy ◽  
Reliable Method ◽  
Cerebral Protection

Use of Anticoagulants, Electroencephalographic Monitoring, and Barbiturate Cerebral Protection in Carotid Endarterectomy

Neurosurgery ◽  
1981 ◽  
Vol 9 (1) ◽  
pp. 1-5 ◽  
Author(s):  
C. E. Gross ◽  
H. P. Adams ◽  
M. D. Sokoll ◽  
T. Yamada
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Endarterectomy ◽  
Unique Feature ◽  
Treatment Protocol ◽  
Burst Suppression ◽  
Cerebral Protection ◽  
Eeg Monitoring ◽  
Specific Risk ◽  
Perioperative Anticoagulation ◽  
The Brain

abstract This paper describes a treatment protocol for threatened stroke in patients amenable to carotid endarterectomy. The protocol includes the use of perioperative anticoagulation, intraoperative electroencephalographic (EEG) monitoring, and hypertension or barbiturates to protect the brain against documented ischemia intraoperatively. The rationale and methods for protecting the patient from the threat of thromboembolism and cerebral ischemia during each of the periods of specific risk are discussed. The most unique feature of this protocol is the use of thiopental-induced EEG burst suppression for ischemia unresponsive to hypertension during carotid clamping, which has obviated the use of a potentially dangerous and cumbersome in-line arterial shunt.

Anesthetics and Cerebral Protection in Patients Undergoing Carotid Endarterectomy

2015 ◽  
Vol 29 (1) ◽  
pp. 178-184 ◽  
Author(s):  
Miomir Jovic ◽  
Dragana Unic-Stojanovic ◽  
Esma Isenovic ◽  
Rizzo Manfredi ◽  
Olivera Cekic ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Protection

scholarly journals Thiopentone Cerebral Protection under EEG Control during Carotid Endarterectomy

1986 ◽  
Vol 14 (1) ◽  
pp. 22-28 ◽  
Author(s):  
R. G. Hicks ◽  
D. R. Kerr ◽  
D. A. Horton
Keyword(s):  
Blood Pressure ◽  
Carotid Endarterectomy ◽  
Burst Suppression ◽  
Cerebral Protection ◽  
Brain Protection ◽  
Temporary Bypass ◽  
Neurological Morbidity ◽  
Eeg Changes

Seventy patients who underwent a total of 77 consecutive carotid endarterectomies were given thiopentone (mean dose 19 mg/kg) under EEG control for cerebral protection during the period of carotid clamping. This technique was used instead of elective insertion of a temporary bypass shunt in response to adverse EEG changes occurring after clamping. The EEG was monitored continuously throughout operation. The EEG burst-suppression pattern with electrically inactive periods of 30-60 seconds was taken as indicating a depth of barbiturate anaesthesia adequate to provide brain protection. Patients exhibited a drop in blood pressure during barbiturate administration: in most the pressure recovered spontaneously but in twenty operations metaraminol was needed to re-establish an adequate pressure before clamping. No adverse cardiological effects were associated with the administration of thiopentone or metaraminol. There was no mortality and no neurological morbidity in this series.

Cerebral protection during carotid endarterectomy

JAMA ◽  
1967 ◽  
Vol 202 (11) ◽  
pp. 1046-1047 ◽  
Author(s):  
J. E. Thompson
Keyword(s):  
Carotid Endarterectomy ◽  
Cerebral Protection

scholarly journals Cerebral Protection with Thiopentone during Combined Carotid Endarterectomy and Clipping of Intracranial Aneurysm

2002 ◽  
Vol 30 (2) ◽  
pp. 219-222 ◽  
Author(s):  
P. P. Mcconkey ◽  
N. D. Kien
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Intracranial Aneurysm ◽  
Carotid Endarterectomy ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Cerebral Protection ◽  
Optimal Dosage ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm

We report a case of carotid endarterectomy and clipping of an ipsilateral internal carotid artery aneurysm in a patient with complete contralateral carotid stenosis. The patient developed an ischaemic electroencephalographic (EEG) tracing on temporary carotid clamping and bypass shunt was contraindicated. We used thiopentone titrated to EEG burst suppression for pharmacological cerebral protection during the subsequent prolonged carotid clamp necessary for carotid endarterectomy. We review the use of thiopentone for this purpose, in particular the evidence for efficacy, mechanism of action and optimal dosage and timing of administration.

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