Benefits and effectiveness of recording somatosensory evoked potentials in surgery on the carotid artery

Zentralblatt für Chirurgie
T UberrückI Gastinger

Abstract

Operative treatment of high-grade carotid stenosis is an established procedure. The question whether a temporary - either selective or routine - shunt is needed, is a matter of controversy, and the decision is based on a number of available monitoring procedures. Within the framework of quality assurance based on the regular collection of our own patient data, carotid thromboendarterectomy (TEA) with recording of somatosensory evoked potentials (SEP) was analysed for its effectiveness. Two non-randomised groups of patients were analysed retrospectively: Group I: 99 carotid TEAs with no recording of SEP (1.1.99-31.12.99); Group II: 139 carotid TEAs with SEP recording (1.1.01-31.12.01). These two groups were unselected in terms of procedure, as also with regard to age, sex, stage or degree of carotid stenosis or surgeon, and were homogeneously distributed. A comparison was made of anaesthesia and operating times, shunt rate and the outcome of the two groups. Additionally, the two subgroups surgery with no shunt, and surgery with shunt, and the subgroups thromboendarterectomy with patchplasty (TEA) and eversion endarterectomy (EEA), were analysed. A temporary shunt was employed in 41 (41.4 %) of the patients in Group I (no SEP rec...Continue Reading

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