title: Determining criteria for shunt placement during carotid endarterectomy. EEG versus back pressure.
abstract: EEG monitoring and carotid back pressure were performed on 100 patients undergoing elective carotid endarterectomy. Shunts were inserted selectively in those patients who showed change in EEG after a trial period of carotid clamping (15%). No patient in the series awoke with a neurologic deficit. Back pressures were significantly lower in the shunted group and these pressures roughly correlated with EEG changes. Only one patient with a back pressure of greater than 40 mmHg had EEG changes and this patient had a recent mild stroke. EEG changes were most frequent in patients with contralateral carotid occlusions and in asymptomatic significant stenoses. EEG is a more discriminating indicator for shunt insertion than back pressure, although a pressure greater than 40 mmHg is safe in patients without recent stroke.
mesh_terms: D001794:Blood Pressure; D002343:Carotid Artery, Internal / Q000502:physiology / Q000601:surgery*; D004569:Electroencephalography; D004691:Endarterectomy / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000175:diagnosis