Use of oculopneumoplethysmography (OPG-Gee) following carotid endarterectomy.
Oculopneumoplethysmography (OPG-Gee) was performed pre- and postoperatively in 100 patients undergoing carotid endarterectomy and 14 patients undergoing nonendarterectomy procedures (aortofemoral or carotid-subclavian bypass). Absolute differences in ocular systolic pressure (OSP) were determined and results were compared with previous criteria. Twelve examinations yielded abnormal findings in the endarterectomy group. Seven patients had associated neurologic deficits and six had occlusion confirmed at reexploration. Five patients were without symptoms; two with profound depressions in OSP were reexplored and thrombosis confirmed whereas three with moderate (15 to 30 mm Hg) depressions in OSP were followed up and remained asymptomatic. Values of OSP were related to the status of the contralateral carotid artery. In the nonendarterectomized patients OSP did not change with general anesthesia or carotid clamping. OPG-Gee is a useful test to screen for postoperative carotid thrombosis. It helps select symptomatic patients with occlusions who might benefit from early reexploration. In asymptomatic patients a profound drop in OSP identifies early occlusion and may be used alone or in concert with angiography to select patients for reoperation.
D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000503:physiopathology; D002339:Carotid Arteries / Q000503:physiopathology / Q000601:surgery; D002340:Carotid Artery Diseases / Q000503:physiopathology / Q000601:surgery*; D002341:Carotid Artery Thrombosis / Q000503:physiopathology / Q000601:surgery; D004691:Endarterectomy / Q000009:adverse effects; D005123:Eye / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D009200:Myocardial Contraction; D010991:Plethysmography; D011184:Postoperative Period; D011300:Preoperative Care; D013599:Systole