Objectives: In this study, we aimed to evaluate and compare the cerebral oximetry monitoring with near-infrared spectroscopy and the mean
stump pressure measurement for the decision of shunting after carotid artery cross-clamping during carotid endarterectomy.
Patients and methods: Between January 2015 and October 2017, a total of 42 patients (33 males, 9 females; mean age 71.3±8.5 years; range,
56 to 92 years) who underwent carotid endarterectomy were retrospectively analyzed. The patients were divided into shunting/non-shunting
groups and patients with postoperative major neurological complications/without complications groups.
Results: Carotid artery cross-clamping caused a significant decrease in regional cerebral oxygen saturation (rSO2) in the shunting group
(p=0.01), while the contralateral remained stable (p=0.121). The mean ipsilateral rSO2 reduction was 35% in the shunting group and
only 6.6% in the non-shunting group (p=0.019). Postoperative hemiplegia developed in three (7.1%) patients in the shunting group whose
ipsilateral rSO2 was not reduced during cross-clamping, despite the mean stump pressure was reduced (p=0.03).
Conclusion: Our study results show that near-infrared spectroscopy can demonstrate much more precise results than stump pressure
measurement in predicting the need for shunting to prevent perioperative major neurological complications after carotid cross-clamping
during carotid endarterectomy.
Key words: Carotid endarterectomy, near-infrared spectroscopy, stump pressure
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