Application of cerebral oxymetry in carotid surgery (Cerebral oximetry and carotid surgery)

(Cerebral oximetry and carotid surgery) During carotid endarterectomy and carotid artery cross-clamping, various methods for monitoring of cerebral perfusion and function are suggested, including electroencephalography, measurement of the stump pressure, transcranial Doppler, somatosensory evoked potentials, regional cerebral oxygen saturation monitoring (NIRS-rSO2) or direct neurological monitoring of the awake patient during carotid cross-clamping. NIRS is a non-invasive monitoring method that may provide useful information on the most appropriate management during the procedure and postoperative recovery period in carotid endarterectomy patients. It is not possible to specify an absolute rSO2 reading as the critical value below which cerebral ischemia may develop. A relative decrease of rSO2 > 20% after carotid occlusion has an elevated negative predictive value - if rSO2 does not decrease, ischemia is unlikely, but a low positive predictive value - a decrease in rSO2 may not always indicate cerebral ischemia.