Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2021 , Vol 30 , Issue 1
Comparing near-infrared spectroscopy monitoring and stump pressure measurement to estimate the need for shunting during carotid artery endarterectomy
Serkan Burç Deşer1
1Department of Cardiovascular Surgery, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey DOI : 10.9739/tjvs.2021.774 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. Keywords : Carotid endarterectomy, near-infrared spectroscopy, stump pressure

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