Key result
Combined transcranial Doppler and electrophysiologic monitoring during carotid endarterectomy detected a 1.8% incidence of cross-clamp intolerance and identified hyperperfusional flow in four cases.
Why the study?
Does combined transcranial Doppler and electrophysiologic monitoring detect perioperative hemodynamic and embolic risks in patients undergoing carotid endarterectomy?
Observational (n=153)
Does combined transcranial Doppler and electrophysiologic monitoring detect perioperative hemodynamic and embolic risks in patients undergoing carotid endarterectomy?
Combined TCD and electrophysiologic monitoring during carotid endarterectomy provides complementary information, allowing for the detection of embolic signals and hyperperfusion that can guide immediate management.
Supports evaluation of combined monitoring to detect hemodynamic risks in CEA; leaves open whether it improves outcomes.
The results of carotid endarterectomy can be improved by reducing the perioperative embolic and hemodynamic risks. Electrophysiologic monitoring, although reliable, cannot provide full information. In this study, we report on the combined use of transcranial Doppler (TCD) and electrophysiologic monitoring in 153 patients undergoing 166 carotid endarterectomy procedures. TCD monitoring confirmed the low incidence of intolerance to cross-clamp (1.8%), showing a good correlation with electrophysiologic monitoring. In addition, it frequently showed embolic signals immediately after clamp release, but never during carotid dissection or in the final operative phases. Furthermore, TCD allowed the detection of hyperperfusional flow patterns in four cases, making immediate and aggressive control of arterial pressure possible.
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Fiori et al. (1997) conducted an observational in Carotid endarterectomy (n=153). Combined transcranial Doppler (TCD) and electrophysiologic monitoring was evaluated on Intolerance to cross-clamp. Combined transcranial Doppler and electrophysiologic monitoring during carotid endarterectomy detected a 1.8% incidence of cross-clamp intolerance and identified hyperperfusional flow in four cases.
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