[Application of cerebral protection to carotid endarterectomy at perioperation, intraoperation, and postoperation].
OBJECTIVE
To evaluate the significance of cerebral protection applied at carotid endarterectomy (CEA) at perioperation, intraoperation, and postoperation.


METHODS
Thirty patients underwent CEA with application of cerebral protection at perioperation, intraoperation, and postoperation in our hospital from January 2002 to August 2005. Perioperative carotid Doppler ultrasound and computed tomography angiography (CTA) were applied in 29 patients and carotid angiography applied in only one patient. The key methods of intraoperative cerebral protection included general anaesthesia, selective shunting, monitoring of transcranial Doppler, and careful manipulation. The methods of postoperative cerebral protection included leaving tracheal cannula and brain ice-bag, maintaining normal blood pressure, and applying dehydrant under guidance by monitoring of transcranial Doppler.


RESULTS
Among all the 30 patients, shunts were used in 10 patients (33%), and angioplasty by patch was applied in 17 patients (57%). No cranial nerve-associated complications or death was documented.


CONCLUSIONS
Application of cerebral protection at CEA at perioperation, intraoperation, and postoperation can effectively prevent the occurance of cranial nerve-associated complications.
Zhang
Fu-Xian
FX
Department of Vascular Surgery, Beijing Shijitan Hospital, Beijing 100038, China. fuxian@263.net
Liu
Wen-Hong
WH
Zhang
Chang-Ming
CM
Hu
Lu
L
Yang
Yong-Bo
YB
Li
Qing
Q
He
Mao-Lin
ML
D000368:Aged; D000768:Anesthesia, General; D004232:Diuretics / Q000008:administration & dosage; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019990:Perioperative Care / Q000379:methods*; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
D004232:Diuretics