Journal of Vascular Surgery
Volume 49, Issue 6 , Pages 1374-1378 , June 2009

Predictors of shunt during carotid endarterectomy with routine electroencephalography monitoring

Received 15 December 2008 ,Accepted 12 February 2009.

References 

  1. North American Symptomatic Carotid Endarterectomy Trial Collaborators. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–453
  2. Barnett HJM, Taylor DW, Eliasziw M, Fox AJ, Ferguson GG, Haynes RB, et al. Benefit of carotid endarterectomy in patients with symptomatic moderate to severe stenosis. N Engl J Med. 1998;339:1415–1425
  3. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  4. Halliday A, Mansfield A, Marro J, Petro C, Petro R, Potter J, et al. ; MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group (Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomized controlled trial). Lancet. 2004;363:1491–1502
  5. Woodworth GF, McGirt MJ, Than KD, Huang J, Perler BA, Tamargo RJ. Selective versus routine intraoperative shunting during carotid endarterectomy: a multivariate outcome analysis. Neurosurgery. 2007;61:1170–1177
  6. Blackshear WM, DiCarlo V, Seifert KB, Connar RG. Advantages of continuous electroencephaloghic monitoring during carotid artery surgery. J Cardiovasc Surg. 1986;27:146–153
  7. Faught E. Loss of high frequency EEG activities as a sensitive indicator of cerebral ischemia. Electroencephalogr Clin Neurophysiol. 1984;58:119p
  8. McGrail KM. Introperative use of electroencephalography as an assessment of cerebral blood flow. Neurosurg Clin North Am. 1996;7:685–692
  9. Harada RN, Comerota AJ, Good GM, Hashemi HA, Hulihan JP. Stump pressure, electroencephalographic changes, and the contralateral carotid artery: another look at selective shunting. Am J Surg. 1995;170:148–153
  10. Salvian AJ, Taylor DC, Hsing YN, Hildebrand HD, Litherland HK, Humer MP, et al. Selective shunting with EEG monitoring is safer than routine shunting for carotid endarterectomy. Cardiovasc Surg. 1997;5:481–485
  11. Schneider JR, Droste JS, Schindler N, Golan JF, Bernstein LP, Rosenberg RS. Carotid endarterectomy with routine electroencephalography and selective shunting: Influence of contralateral internal carotid artery occlusion and utility in prevention of perioperative strokes. J Vasc Surg. 2002;35:1114–1122
  12. Cho I, Smullens SN, Streletz LJ, Fariello RG. The value of intraoperative EEG monitoring during carotid endarterectomy. Ann Neurol. 1986;20:508–512
  13. Plestis KA, Loubser P, Mizrachi EM, Kantis G, Jiang ZD, Howell JF. Continuous electroencephalography monitoring and selective shunting reduces neurological morbidity rates in carotid endarterectomy. J Vasc Surg. 1997;25:620–628
  14. Taylor DC, Strandness DE. Carotid artery duplex scanning. J Clin Ultrasound. 1987;15:635–644
  15. Jacobowitz GR, Rockman CB, Lamparello PJ, Adelman MA, Schanzer A, Woo D, et al. Causes of perioperative stroke after carotid endarterectomy: special considerations in symptomatic patients. Ann Vasc Surg. 2001;15:19–24
  16. Smith JL, Evans DH, Fan L, Gaunt ME, London NJ, Bell PR, et al. Interpretation of embolic phenomenon during carotid endarterectomy. Stroke. 1995;26:2281–2284
  17. Steed DL, Peitaman AB, Grundy BL, Webster MW. Causes of stroke in carotid endarterectomy. Stroke. 1982;92:634–641
  18. de Borst GJ, Moll FL, van de Pavoordt HD, Mauser HW, Kelder JC, Acherstaf RG. Stroke from carotid endarterectomy: when and how to reduce perioperative stroke?. Eur J Vasc Surg. 2001;21:484–489
  19. Pinkerton JA. EEG as a criterion for shunt need in carotid endarterectomy. Ann Vasc Surg. 2002;16:756–761
  20. Bond R, Rerkasem K, Counsell C, Salinas R, Naylor R, Warlow CP, et al. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Cochrane Database Syst Rev. 2002;2:CD000190.
  21. Ballotta E, Dagiau G, Saladini M, Bottio T, Abbruzzese E, Meneghetti G, et al. Results of electroencephalographic monitoring during 369 consecutive carotid atery revascularizations. Eur Neurol. 1997;37:43–47
  22. Aleksic M, Heckenkamp J, Gawenda M, Reichest V, Brunkwall J. Evaluation of changes of systemic blood pressure and shunt incidence in CEA. Eur J Vasc Endovasc Surg. 2007;34:540–545
  23. Barman AA, Batiuchok W, Creedon JJ, Anban T. Carotid endarterectomy without temporary shunt: importance of pharmacological control of blood pressure. N Y State J Med. 1983;83:697–698

 Competition of interest: none.

PII: S0741-5214(09)00488-1

doi: 10.1016/j.jvs.2009.02.206

Journal of Vascular Surgery
Volume 49, Issue 6 , Pages 1374-1378 , June 2009

Article Tools

* Image Usage & Resolution