title: The effectiveness of regional cerebral oxygen saturation monitoring using near-infrared spectroscopy in carotid endarterectomy.
abstract: Nineteen patients (20 operations) underwent elective carotid endarterectomy without arterial shunt. Carotid cross-clamping caused a significant decrease (from 61.2% to 49.5%, 19.1% decrease from the preclamp baseline) of the ipsilateral cerebral oxygen saturation and it increased to 65.6% after declamping. Cross-clamping also caused a significant decrease (from 2.9 Hz to 1.6 Hz) of the ipsilateral electroencephalogram main frequency and it increased to 3.6 Hz after declamping. Asymmetry of main frequency which was greater than 0.7 Hz was observed when that of oxygen saturation decreased more than 25% during cross-clamping. The reported data indicate that cerebral oxygen saturation less than 54-56.1% and its decrease more than 15.6-18.2% is found to be a predictor of neurologic compromise. In this study, the asymmetry of cerebral oxygen saturation more than 25% was also found to be a risk. Arterial shunt should be used in haemodynamically high risk cases.
authors.affiliation: Department of Neurosurgery, Chukyo Hospital, Sanjo 1-1-10, Minami-ku, Nagoya city, Aichi 457-0866, Japan.
authors.forename: Oyama
authors.initials: O
authors.lastname: Hirofumi
authors.forename: Endoh
authors.initials: E
authors.lastname: Otone
authors.forename: Iizuka
authors.initials: I
authors.lastname: Hiroshi
authors.forename: Ikeda
authors.initials: I
authors.lastname: Satosi
authors.forename: Inoue
authors.initials: I
authors.lastname: Shigeo
authors.forename: Nakashima
authors.initials: N
authors.lastname: Yasuhiro
authors.forename: Shibuya
authors.initials: S
authors.lastname: Masato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D002339:Carotid Arteries / Q000601:surgery*; D002560:Cerebrovascular Circulation; D003250:Constriction; D004569:Electroencephalography; D004691:Endarterectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D019265:Spectroscopy, Near-Infrared
chemical_list: D010100:Oxygen