Document Detail

EEG monitoring of carotid endarterectomy with routine patch-graft angioplasty: an experience in a large series.
MedLine Citation:
PMID:  1488039     Owner:  NLM     Status:  MEDLINE    
Four hundred and thirty-nine carotid endarterectomies (CEAs) with routine use of patchgraft angioplasty were performed in 375 patients; the indwelling shunt was used only in patients showing clamp-related EEG abnormalities. Five patients showed EEG abnormalities just after head positioning, which reversed after removal of head hyperextension; three cases suffered EEG flattening due to severe bradycardia or cardiac arrest before carotid clamping, which promptly reversed after treatment. Clamp-related EEG abnormalities appeared in 106 operations (24.2%) and all reversed after the insertion of the indwelling shunt; patients with occlusion of the contralateral internal carotid artery showed a 68.8% rate of EEG clamp-related changes. The short term follow-up (one month after the operation) showed six minor strokes with complete recovery (1.37%), one intraoperative stroke (0.23%), three delayed major strokes (0.69%) and three neurological deaths (0.69%). The long-term follow-up over an average of 42 months showed a 3.7% rate of relevant neurological complications (ie permanent deficits + death) and a 3.16% rate significant restenosis or occlusion of the operated carotid artery. Our results show that the routine use of EEG monitoring and patch-graft angioplasty allow to perform CEAs with a very high degree of safety, improving the clinical course of the disease.
E Facco; G P Deriu; B Donà; E Ballotta; M Munari; F Grego; A U Behr; F Baratto; L Franceschi; G P Giron
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurophysiologie clinique = Clinical neurophysiology     Volume:  22     ISSN:  0987-7053     ISO Abbreviation:  Neurophysiol Clin     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1993-02-22     Completed Date:  1993-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804532     Medline TA:  Neurophysiol Clin     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  437-46     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care, University of Padua, Italy.
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MeSH Terms
Aged, 80 and over
Cerebrovascular Disorders / etiology,  prevention & control
Endarterectomy, Carotid / adverse effects,  methods*
Follow-Up Studies
Middle Aged
Monitoring, Intraoperative

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