title: The importance of internal carotid artery occlusion tolerance test in carotid endarterectomy under locoregional anesthesia.
abstract: Carotid endarterectomy is considered a safe and effective method for preventing stroke in the short and long term in patients with severe carotid stenosis. The internal carotid artery (ICA) occlusion tolerance test was performed to evaluate cerebral tolerance during temporary carotid occlusion, defined as the capacity of the cerebral hemisphere to maintain adequate cerebral blood flow during occlusion of the ICA. Thus, the aim of the present study is to determine the importance of this test in patients undergoing carotid endarterectomy.
  
  
  
  From August 2008 to May 2015, 115 consecutive patients (39 female, 77 male) were referred for carotid endarterectomy at the Santa Casa de Belo Horizonte by the main author.
  
  
  
  Of the 115 patients who participated in the study, 107 were submitted to carotid endarterectomy. Morbi-mortality was 2.7 %. The presence of deficits during the ICA occlusion tolerance test in less than 30 s was associated with the presence of complications. Among the 104 patients who showed no deficits during the test, only one case (0.9 %) presented complications, while among the three cases that showed deficits during the test and who were submitted to carotid endarterectomy, two cases presented complications (p < 0.0001).
  
  
  
  The carotid endarterectomy under locoregional anesthesia is a safe surgical procedure. The internal carotid artery occlusion tolerance test can help identify high-risk patients who have been assigned this treatment.
authors.affiliation: Department of Neurosurgery, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil. mdellaretti@mac.com.|Instituto de Ensino Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil. mdellaretti@mac.com.|Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. mdellaretti@mac.com.|Department of Neurosurgery, Hospital Mater Dei, Belo Horizonte, Minas Gerais, Brazil. mdellaretti@mac.com.
authors.forename: Marcos
authors.initials: M
authors.lastname: Dellaretti
authors.affiliation: Instituto de Ensino Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Laura T
authors.initials: LT
authors.lastname: de Vasconcelos
authors.affiliation: Department of Neurosurgery, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Jules
authors.initials: J
authors.lastname: Dourado
authors.affiliation: Department of Neurosurgery, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Renata F
authors.initials: RF
authors.lastname: de Souza
authors.affiliation: Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Renato R
authors.initials: RR
authors.lastname: Fontoura
authors.affiliation: Department of Neurosurgery, Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.|Instituto de Ensino Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.|Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.|Department of Neurosurgery, Hospital Mater Dei, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Atos A
authors.initials: AA
authors.lastname: de Sousa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D002343:Carotid Artery, Internal / Q000601:surgery; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*
keywords: Carotid endarterectomy; Internal carotid artery occlusion tolerance test; Locoregional anesthesia; Stroke