PMID: 8458444Mar 1, 1993Paper

Cerebral haemodynamics during carotid cross-clamping

European Journal of Vascular Surgery
G R PistoleseV Faraglia

Abstract

Carotid artery cross-clamping ischaemia during carotid endarterectomy (CEA) causes 5-30% of perioperative neurological deficits. This study was performed to identify possible clinical situations at higher risk for carotid cross-clamping ischaemia. 606 consecutive patients underwent CEA and were retrospectively studied; they were grouped according to risk factors, presence of associated vascular diseases, clinical pattern, angiographic and CT scan findings. Stump pressure measurement was provided in all patients, perioperative monitoring during CEA was performed by electroencephalogram (EEG) in 469 (77%) and somatosensorial evoked potentials (SEP) in 137 (23%). Local anaesthesia was used in 88 (14.5%) patients. Ischaemic changes during carotid cross-clamping were registered in 118 patients (19.5%). The incidence of cross-clamping ischaemia was then related to different factors; it affected 5.6% of asymptomatics, 25.4% of patients with fixed stroke and 38.5% of those with stenosis and contralateral occlusion. Angiographic and clinical correlation showed that patients with more severe lesions are mostly affected by clamping ischaemia (up to 55% in those with stroke and stenosis with contralateral occlusion). Age, hypertension and ...Continue Reading

References

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Citations

Jul 29, 1998·Electroencephalography and Clinical Neurophysiology·J M Guérit
Nov 1, 1993·European Journal of Vascular Surgery·G R PistoleseA A Marchetti
Jun 13, 2006·Journal of Vascular Surgery·Massimiliano M Marrocco-TrischittaRoberto Chiesa
Feb 7, 2001·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·G H VisserB C Eikelboom

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