scholarly journals The effect of cerebral oximeter use on the shunt placement concerning carotid endarterectomy surgery

2019 ◽  
Vol 22 (2) ◽  
pp. 158
Author(s):  
Dilek Ceyhan ◽  
Cengiz Ovali
Keyword(s):  
Carotid Endarterectomy ◽  
Shunt Placement ◽  
Cerebral Oximeter

scholarly journals Determining Criteria for Shunt Placement During Carotid Endarterectomy

1983 ◽  
Vol 198 (5) ◽  
pp. 642-645 ◽  
Author(s):  
JOHN J. RICOTTA ◽  
MAURICE H. CHARLTON ◽  
JAMES A. DEWEESE
Keyword(s):  
Carotid Endarterectomy ◽  
Shunt Placement

Distal Cervical Carotid Dissection after Carotid Endarterectomy: A Complication of Indwelling Shunt?

Neurosurgery ◽  
1986 ◽  
Vol 19 (3) ◽  
pp. 441-445 ◽  
Author(s):  
Christopher M. Loftus ◽  
Gregg N. Dyste ◽  
Stephen J. Reinarz ◽  
William L. Hingtgen
Keyword(s):  
Carotid Endarterectomy ◽  
Surgical Techniques ◽  
Carotid Dissection ◽  
Distal Embolization ◽  
Controversial Subject ◽  
Shunt Placement ◽  
Operative Site ◽  
Technical Factors ◽  
Protective Intervention

Abstract Technical factors and surgical techniques in carotid endarterectomy remain a controversial subject. The use of an indwelling arterial shunt has theoretical advantages in assuring intraoperative hemispheric perfusion and affording a more relaxed surgical environment. There has been little clinical demonstration, however, of superior results with carotid shunting. Although champions of routine shunting argue that it is a benign protective intervention, the possibilities of distal embolization or intimal disruption exist. The authors report a case of cervical carotid dissection far distal to the operative site that they postulate resulted from intimal disruption after routine shunt placement. This devastating complication from an otherwise benign procedure prompts reconsideration of the benefits and risks of routine shunt placement.

Association of biomarker S100B and cerebral oximetry with neurological changes during carotid endarterectomy performed in awake patients

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 285-293
Author(s):  
Matej Makovec ◽  
Klemen Kerin ◽  
Milan Skitek ◽  
Aleš Jerin ◽  
Tomislav Klokočovnik
Keyword(s):  
Serum Concentration ◽  
Carotid Endarterectomy ◽  
Near Infrared ◽  
Neurological Symptoms ◽  
Cerebral Oximetry ◽  
S100b Protein ◽  
Serum S100b ◽  
Evaluation Time ◽  
Before And After ◽  
Cerebral Oximeter

Summary. Background: This study attempted to correlate neurological symptoms in awake patients undergoing carotid endarterectomy (CEA) under local anaesthesia (LA) with serum concentration of S100B protein and measurement of cerebral oximetry with near-infrared spectroscopy (NIRS). Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA during an 18-month period were prospectively evaluated. A cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum concentration of the S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Neurological deterioration occurred (neurological symptoms group) in 7 (10.9 %) operations. In 57 (89.1 %) operations, the patients were neurologically stable (no neurological symptoms group). Results: The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B ( P = .040). The cut-off of 22.5 % of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO2 decline and neurological symptoms ( P = .675). Two (3.1 %) perioperative strokes occurred. Conclusions: We found a correlation between neurological symptoms and serum S100B protein increase. However, because of the long evaluation time of serum S100B, this monitoring technique cannot be performed during CEA.

Triple-Balloon Shunt Placement for Carotid Endarterectomy: A Novel Intraluminal Shunt Designed to Preserve the Internal and External Carotid Blood Flow

2014 ◽  
Vol 82 (1-2) ◽  
pp. 239.e5-239.e8
Author(s):  
Tsutomu Hitotsumatsu ◽  
Ataru Nishimura ◽  
Keisuke Ido ◽  
Katsuya Ishido ◽  
Osamu Ito
Keyword(s):  
Blood Flow ◽  
Carotid Endarterectomy ◽  
External Carotid ◽  
Carotid Blood Flow ◽  
Shunt Placement ◽  
Intraluminal Shunt
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