Cerebral monitoring during carotid endarterectomy using transcranial cerebral oximetry

Abstract

OBJECTIVE: This study aimed to evaluate the outcomes of carotid endarterectomies (CEA) performed using transcranial cerebral oximetry as cerebral monitoring METHODS: This single-center study included patients treated surgically for signifi cant stenosis of the internal carotid artery (ICA) from January 2012 to December 2017 RESULTS: Of the 654 patients, 267 were asymptomatic, and 387 were symptomatic. Eversion CEA was performed in 64.8 %, and patched conventional CEA in 35.2 % of all patients. Totally 11.4 % of all patients had a shunt inserted; all patients with the inserted shunt had the conventional pathed CEA. Severe postoperative complications occurred in 1.5 % of asymptomatic patients and 2.6 % of symptomatic patients. The stroke and death ratio in the shunted group was 2.7 %, and in the non-shunted group, 2.1 % (p = 0.7). We found no signifi cant difference in severe postoperative complications between the shunted and non-shunted group. Further, we found the male gender (p = 0.005), coronary artery disease (p = 0.01), and ongoing smoking (p = 0.003) to be signifi cantly associated with neurological symptoms of the ICA stenosis. We also confi rmed current tobacco smoking to be signifi cantly associated with the occurrence of postoperative stroke and death (p = 0.005) CONCLUSION: We found transcranial cerebral oximetry to be reliable in the determination of shunt insertion