Document Detail

Cerebral oximetry monitoring during carotid endarterectomy: effect of carotid clamping and shunting.
MedLine Citation:
PMID:  14671695     Owner:  NLM     Status:  MEDLINE    
Cerebral oximetry is a simple method of measuring regional cerebral oxygen saturation (rSO(2)). One promising application is its use during carotid endarterectomy (CEA) to help minimize the risk of perioperative stroke. The authors used the INVOS-4100 cerebral oximeter at several steps during CEA to measure the effect of carotid clamping and shunting on rSO(2). The authors prospectively evaluated 42 consecutive CEAs in 40 patients. All had CEA under general anesthesia with the routine use of a Javid shunt. The INVOS-4100 oximeter was used to measure rSO(2) before clamping (t1), after clamping but before shunting (t2), 5 minutes after shunt insertion (t3), and after patch closure with reestablished flow (t4). The Wilcoxon signed-rank and rank-sum tests were used for analysis. Clamping of the internal carotid artery (t1 vs t2) resulted in a drop of ipsilateral rSO(2) by -12.3% (p < 0.001). Shunt insertion (t2 vs t3) increased rSO(2) by 10.9% (p < 0.001). Contralateral rSO(2) for the same time periods was insignificant. Patients with preoperative neurologic symptoms had a greater decrease in rSO(2) after clamping (-18.4%) compared with a decrease of -10.4% in asymptomatic patients (p = 0.037). Cerebral oximetry monitoring is simple and inexpensive. The study showed statistically significant changes in rSO(2) as a result of clamping and shunting of the carotid artery. Symptomatic patients had a greater drop in rSO(2).
Salvador A Cuadra; Jonathan S Zwerling; Martin Feuerman; Antonios P Gasparis; George L Hines
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Vascular and endovascular surgery     Volume:  37     ISSN:  1538-5744     ISO Abbreviation:  Vasc Endovascular Surg     Publication Date:    2003 Nov-Dec
Date Detail:
Created Date:  2003-12-12     Completed Date:  2004-03-24     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  101136421     Medline TA:  Vasc Endovascular Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  407-13     Citation Subset:  IM    
Winthrop University Hospital Department of Surgery, Mineola, NY, USA.
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MeSH Terms
Blood Pressure
Brain / metabolism
Brain Ischemia / etiology
Endarterectomy, Carotid* / adverse effects
Middle Aged
Oxygen / blood
Regional Blood Flow
Reg. No./Substance:

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