title: Carotid artery stump pressure: its variability when measured serially.
abstract: At 189 operations in 174 patients, carotid artery stump pressure (CSP) was measured serially to determine variability during carotid endarterectomy with eucarbic general anesthesia. Overall, 34 of 174 (19.5%) had significant variation in CSP which would have affected selective use of a bypass shunt based on CSP criteria. In those with CSP initially below 50 torr, 26 of 76 (34%) rose above 50 torr even, though systemic pressure was constant or declined. Eight of 113 pts (7%) with initial CSP equal to or above 50 torr subsequent had CSP below 50 torr. CSP did not vary as a function of age, sex, intracranial disease judged by biplanar arteriography, or contralateral carotid stenosis but did vary with preoperative status. Asymptomatic patients had CSP above 50 torr in a high proportion of cases, 24 of 27 (89%) unlike those with TIA, 72 of 116 (62%) or prior stroke, 17 of 31 (54%) (P = 0.003). We conclude that carotid stump pressure is variable in many patients which may account for some of the conflicting observations on the need for shunts in carotid surgery.
authors.affiliation: Section of Vascular Surgery, Virginia Mason Clinic, Seattle, Washington.
authors.forename: H G
authors.initials: HG
authors.lastname: Beebe
authors.forename: C
authors.initials: C
authors.lastname: Starr
authors.forename: D
authors.initials: D
authors.lastname: Slack
mesh_terms: D001794:Blood Pressure; D001795:Blood Pressure Determination; D002340:Carotid Artery Diseases / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000502:physiology*; D004691:Endarterectomy; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000601:surgery*; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies