Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Dual Monitoring with Stump Pressure and Electroencephalography During Carotid Endarterectomy

  • Chang, Jee Won (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Kim, Su Wan (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Seogjae (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Jonggeun (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Ku, Min Jung (Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine)
  • Received : 2016.07.01
  • Accepted : 2016.10.17
  • Published : 2017.04.05
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Abstract

Background: Intraoperative monitoring during carotid endarterectomy is crucial for cerebral protection. We investigated the results of carotid endarterectomy under dual monitoring with stump pressure and electroencephalography. Methods: We retrospectively reviewed the medical records of 50 patients who underwent carotid endarterectomy between March 2010 and February 2016. We inserted a temporary shunt if the stump pressure was lower than 35 mm Hg or if any intraoperative change was observed on electroencephalography. Results: Seventeen (34%) patients used a temporary shunt, and the mean stump pressure was 26.8 mm Hg in the shunt group and 46.5 mm Hg in the non-shunt group. No postoperative mortality or bleeding occurred. Postoperatively, there were 3 cases (6%) of minor stroke, all of which took place in the shunt group. A comparison of the preoperative and the intraoperative characteristics of the shunt group with those of the non-shunt group revealed no statistically significant difference between the 2 groups (p<0.01). Conclusion: Dual monitoring with stump pressure and electroencephalography was found to be a safe and reliable monitoring method with results comparable to those obtained using single monitoring. Further study should be performed to investigate the precise role of each monitoring method.

Keywords

References

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  1. Selective Shunting Based on Dual Monitoring with Electroencephalography and Stump Pressure for Carotid Endarterectomy vol.34, pp.3, 2018, https://doi.org/10.5758/vsi.2018.34.3.72
  2. Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia vol.52, pp.6, 2019, https://doi.org/10.5090/kjtcs.2019.52.6.392