title: Cerebral monitoring of somatosensory evoked potentials during carotid surgery: a review of 100 cases.
abstract: The purpose of this study was to evaluate immediate and middle-term results of surgical carotid artery revascularization (CAR) with cerebral monitoring of intraoperative somatosensory evoked potentials (SEPs). Between 1998 and 2004, a total of 100 CARs in 86 patients were performed under general anesthesia with SEP monitoring. A shunt was inserted if SEP amplitude decreased by 50% or latency time increased by 10%. Immediate and middle-term results were analyzed retrospectively. The shunt insertion rate was 5%. Two transient ischemic attacks were observed, and one patient died postoperatively due to myocardial infarction. The cumulative stroke and death rate was 1% at 30 days. Intraoperative SEP monitoring with selective shunt placement can be used safely for carotid surgery. Randomized studies will be necessary to determine the respective indications for various cerebral monitoring techniques.
authors.affiliation: Department of Visceral and Vascular Surgery, Val de Grace Military Teaching Hospital, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Baton
authors.forename: Pascal
authors.initials: P
authors.lastname: Szym
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Hoffmann
authors.forename: Marc
authors.initials: M
authors.lastname: Borne
authors.forename: Yves
authors.initials: Y
authors.lastname: Diraison
authors.forename: Bernard
authors.initials: B
authors.lastname: Baranger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000601:surgery*; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures