Korean J Thorac Cardiovasc Surg.  2017 Apr;50(2):94-98. 10.5090/kjtcs.2017.50.2.94.

Dual Monitoring with Stump Pressure and Electroencephalography During Carotid Endarterectomy

• Chang JW
• Kim SW
• Lee S
• Lee J
• Ku MJ

• KMID: 2381914
• DOI: http://doi.org/10.5090/kjtcs.2017.50.2.94

Abstract

BACKGROUND
Intraoperative monitoring during carotid endarterectomy is crucial for cerebral protection. We investigated the results of carotid endarterectomy under dual monitoring with stump pressure and electroencephalography.
METHODS
We retrospectively reviewed the medical records of 50 patients who underwent carotid endarterectomy between March 2010 and February 2016. We inserted a temporary shunt if the stump pressure was lower than 35 mm Hg or if any intraoperative change was observed on electroencephalography.
RESULTS
Seventeen (34%) patients used a temporary shunt, and the mean stump pressure was 26.8 mm Hg in the shunt group and 46.5 mm Hg in the non-shunt group. No postoperative mortality or bleeding occurred. Postoperatively, there were 3 cases (6%) of minor stroke, all of which took place in the shunt group. A comparison of the preoperative and the intraoperative characteristics of the shunt group with those of the non-shunt group revealed no statistically significant difference between the 2 groups (p <0.01).
CONCLUSION
Dual monitoring with stump pressure and electroencephalography was found to be a safe and reliable monitoring method with results comparable to those obtained using single monitoring. Further study should be performed to investigate the precise role of each monitoring method.

Keyword

Endarterectomy, carotid; Intraoperative neurophysiological monitoring; Stroke; Carotid artery disease

MeSH Terms

Carotid Artery Diseases
Electroencephalography*
Endarterectomy, Carotid*
Hemorrhage
Humans
Intraoperative Neurophysiological Monitoring
Medical Records
Methods
Monitoring, Intraoperative
Mortality
Retrospective Studies
Stroke