title: [MONITORING OF CEREBRAL OXYGENATION AND COGNITIVE FUNCTION IN CAROTID ENDARTERECTOMY: THE ROLE OF TRANSIENT BYPASS OF CAROTID ARTERY].
abstract: BACKGROUND AND OBJECTVE: Carotid endarterectomy (CEE) is an effective surgical technique to prevent cerebral ischemia and stroke, but can be associated with intervention-related complications. The surgical shunting of the intervention area may reduce the risk of the intraoperative ipsilateral cerebral ischemia following the carotid artery clamping but is controversial. The goal of this study was to compare the cerebral tissue oxygen saturation (SctO2) and early changes of cognitive functions in CEE in the settings of transient vascular bypass and without this method.
  
  
  METHODS
  45 adult patients were randomized to either the bypass group (the Bypass group, n = 24) or the Controls / No Bypass (the Control group, n = 21). All patients were monitored for invasive arterial pressure, SpO, EtCO,, and cerebral oxygenation (SctO2, Fore-Sight, CASMED, USA) over the contra- and ipsilateral frontal head areas. The cognitive functions were assessed using series of Montreal Cognitive Assessment score (MoCA) before the intervention, and on 6 and 36 hrs after the CEE.
  
  
  RESULTS
  We did not find intergroup differences in the surgery duration, degree of stenosis and baseline cognitive function. The values of SctO2 reduced significantly only above contralateral side; these changes were attenuated in the shunt group. There were no intergroup differences in postoperative cognitive function.
  
  
  CONCLUSIONS
  Empiric transient vascular bypass during carotid endarterectomy did not result in significant changes of the ipsilateral cerebral oxygenation, hyperperfusion and cognitive function, but attenuated the decrease of SctO2 over the contralateral hemisphere.
authors.forename: M Y
authors.initials: MY
authors.lastname: Obraztsov
authors.forename: V V
authors.initials: VV
authors.lastname: Kuzkov
authors.forename: P I
authors.initials: PI
authors.lastname: Lenkin
authors.forename: A A
authors.initials: AA
authors.lastname: Klyagin
authors.forename: O Yu
authors.initials: OY
authors.lastname: Ivashchenko
authors.forename: M M
authors.initials: MM
authors.lastname: Sokolova
authors.forename: N Ya
authors.initials: NY
authors.lastname: Shemyakina
authors.forename: A R
authors.initials: AR
authors.lastname: Grushitsyn
authors.forename: V M
authors.initials: VM
authors.lastname: Gorenkov
authors.forename: M Yu
authors.initials: MY
authors.lastname: Kirov
mesh_terms: D016893:Carotid Stenosis / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D002536:Cerebral Arteries / Q000601:surgery*; D002560:Cerebrovascular Circulation; D003071:Cognition / Q000502:physiology*; D016894:Endarterectomy, Carotid / Q000379:methods* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D064926:Neurophysiological Monitoring; D010092:Oximetry / Q000379:methods*; D016896:Treatment Outcome