Key result
A ~21% regional oxygen saturation drop after cross-clamping identifies shunt need during carotid endarterectomy.
Why the study?
Does cerebral oximetry (rSO2) correlate with stump pressure to accurately indicate the need for shunting during carotid endarterectomy?
Observational (n=60)
Does cerebral oximetry (rSO2) correlate with stump pressure to accurately indicate the need for shunting during carotid endarterectomy?
Cerebral oximetry provides a sufficient reflection of cerebral oxygenation during carotid endarterectomy compared to stump pressure, offering specific reduction thresholds to guide shunt insertion.
rSO2 thresholds may aid shunt decisions in CEA; leaves open prospective validation versus stump pressure.
The purpose of this work is to investigate the correlation between regional oxygen saturation (rSO(2)) changes and stump pressure (SP) during cross-clamping of the internal carotid artery in carotid endarterectomy (CEA) and verify the perspectives of rSO(2) to become a criterion for shunting. Sixty consecutive CEAs under general anesthesia were studied prospectively. Selective shunting was based on SP ≤40 mmHg exclusively. Regression analysis with high order terms and receiver operating characteristic analysis were performed to investigate the association between ΔrSO(2)(%) and SP and to determine an optimal ΔrSO(2)(%) threshold for shunt insertion. A quadratic association between ΔrSO(2)(%) and SP was documented regarding the baseline to one and five minutes after cross-clamping intervals. A cut-off of 21 and 10.1% reduction from the baseline recording was identified as optimal for the distinction between patients needed or not a shunt regarding the first and fifth minute after cross-clamping, respectively. In conclusion, cerebral oximety reflects sufficiently cerebral oxygenation during CEA compared with SP, providing a useful mean for cerebral monitoring.
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Tambakis et al. (2011) conducted an observational in Carotid endarterectomy (n=60). Cerebral oximetry (regional oxygen saturation) vs. Stump pressure was evaluated on Correlation between regional oxygen saturation changes and stump pressure during cross-clamping. Regional oxygen saturation reductions of 21% and 10.1% at one and five minutes after cross-clamping optimally identified patients needing a shunt during carotid endarterectomy.
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