[New methods on the subject of peroperative neurophysiological monitoring in vascular and orthopedic surgery].
The neurological and neuropsychological complications of vascular and orthopedic surgery can be prevented by the early detection of the ischemic penumbra, that is, the stage at which the ischemic nervous structures are no more functional, but still alive and salvageable by reperfusion. This can be achieved by intraoperative neuromonitoring of the electroencephalogram and evoked potentials. We illustrate how these techniques led to improvement of the surgical strategy and patient outcome in carotid endarterectomies, descending aorta surgery and surgery performed under deep hypothermic circulatory arrest.
Guérit
J M
JM
Service de Chirurgie vasculaire, Cliniques universitaires St Luc, U.C.L., Bruxelles.
D001013:Aorta, Thoracic / Q000601:surgery; D001927:Brain Diseases / Q000517:prevention & control*; D002545:Brain Ischemia / Q000517:prevention & control; D004569:Electroencephalography; D016894:Endarterectomy, Carotid / Q000009:adverse effects; D005071:Evoked Potentials / Q000502:physiology; D006324:Heart Arrest, Induced / Q000009:adverse effects; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D007431:Intraoperative Complications / Q000517:prevention & control*; D016343:Monitoring, Intraoperative; D009482:Neurophysiology; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000517:prevention & control*; D015424:Reperfusion; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects*