The value of carotid stump pressure and EEG monitoring in predicting carotid cross-clamping intolerance.
The authors analyse their experience with carotid stump pressure (CSP) and electro-encephalogram (EEG) monitoring in relation to the incidence of peroperative stroke during internal carotid artery reconstruction. A series of 215 patients is presented, among whom six (2.8%) developed a peroperative stroke. The stroke rate in patients with a CSP below 50 mm Hg (n = 92) was 7% (2/27) without a shunt and 3% (2/62) with the use of a shunt. The respective numbers for patients with a CSP equal to or above 50 mmHg were 1.7% (2/123) and 0% (0/10). The EEG remained normal after cross clamping in 180 cases (84%): the incidence of stroke was 1.5% (2/138) without and 5% (2/42) with a shunt. A shunt was used in 33 of the 35 patients with EEG changes after cross clamping. None of them sustained a stroke in contrast to both patients where despite EEG changes no shunt was used (respective stroke rates 0% and 100%). It is concluded that regarding cerebral function, EEG monitoring provides more accurate information than CSP.
Lacroix
H
H
Department of Vascular Surgery, Univ. Clin., Gasthuisberg, Leuven, Belgium.
Van Gertruyden
G
G
Van Hemelrijck
J
J
Nevelsteen
A
A
Suy
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002339:Carotid Arteries / Q000502:physiology / Q000601:surgery*; D002561:Cerebrovascular Disorders / Q000601:surgery*; D004569:Electroencephalography; D004691:Endarterectomy / Q000379:methods; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods / Q000401:mortality