Carotid endarterectomy: a study of cerebral oxygen saturation vs stump pressure.
OBJECTIVE
Carotid endarterectomy (CEA) is an established surgical procedure for treatment of internal carotid artery (ICA) stenosis. To determine whether or not a carotid shunt is necessary to place, some surgeons measure the stump pressure. We conducted the current study in order to identify whether or not cerebral oxygen saturation (rS02%) can serve as another quantitative measurement to determine the need of carotid shunt during CEA.


METHODS
Ten patients who underwent CEA under general anesthesia were studied. The stump pressure was measured during ICA clamping and rSO2% was measured during three phases: A) prior to ICA clamping, B) during ICA clamping and C) after ICA declamping. The data were subjected to one-way ANOVA and correlation coefficient analysis. The mean age was 62+/-7 yr and the mean body weight was 66+/-7kg.


RESULTS
The stump pressure and rSO2% mean values were 45+/-9 mmHg and 57+/-7% respectively during ICA clamping. Correlation coefficient revealed significant positive relationship, r = 0.724(P = 0.009).


CONCLUSIONS
rSO2% may serve as another quantitative measurement to determine the need for carotid shunt during CEA surgery. Due to the small number of cases in the current study, the critical rSO2% which warrants carotid shunt placement could not be identified. Therefore, large number of patients are required to define the critical rSO2% during CEA surgery.
El-Dawlatly
Abdelazeem Ali
AA
Dept of Anaesthesia, College of Med, King Saud University, Riyadh 11461, Saudi Arabia. dawlatly@ksu.edu.sa
D000368:Aged; D001794:Blood Pressure; D002343:Carotid Artery, Internal / Q000503:physiopathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D003250:Constriction; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010100:Oxygen / Q000097:blood*
D010100:Oxygen