These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: The potential benefits and the role of cerebral monitoring in carotid endarterectomy.
    Author: Pennekamp CW, Moll FL, de Borst GJ.
    Journal: Curr Opin Anaesthesiol; 2011 Dec; 24(6):693-7. PubMed ID: 21971393.
    Abstract:
    PURPOSE OF REVIEW: The benefit of carotid endarterectomy (CEA) in patients with symptomatic severe carotid stenosis is highly dependent on the perioperative stroke rate. Cerebral monitoring plays an important role in reducing the perioperative stroke rate as it allows detection of the main causes of perioperative stroke, being embolism, intraoperative hypoperfusion and postoperative hyperperfusion syndrome. However, some physicians doubt about the benefit of cerebral monitoring and consider it costly and time consuming. The aim of this review is to provide an overview of the available cerebral monitoring modalities and their role in CEA. RECENT FINDINGS: Electroencephalography, transcranial Doppler, stump pressure and sensory-evoked potentials, are known and used for years. Near-infrared spectroscopy is a relatively new valuable technique, as it is noninvasive, easy to apply and applicable in all CEA patients, but remains to be validated. SUMMARY: In our opinion, cerebral monitoring during CEA is essential because it provides direct information regarding new neurological deficits, which might otherwise be missed. Intraoperative cerebral monitoring provides immediate feedback to the treating physician allowing prompt correction in tissue handling. Several monitoring modalities are available for cerebral monitoring in CEA, but no single test is comprehensive. Therefore, a combination of several monitoring modalities with each specific strength not only during but also after CEA is recommended to cover all needs and reduce the perioperative stroke rate.
    [Abstract] [Full Text] [Related] [New Search]