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KMID : 0364020170500020094
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Korean Journal of Thoracic and Cardiovascular Surgery
2017 Volume.50 No. 2 p.94 ~ p.98
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Dual Monitoring with Stump Pressure and Electroencephalography During Carotid Endarterectomy
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Chang Jee-Won
Kim Su-Wan
Lee Seog-Jae
Lee Jong-Geun
Ku Min-Jung
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Abstract
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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.
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KEYWORD
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Endarterectomy, carotid, Intraoperative neurophysiological monitoring, Stroke, Carotid artery disease
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