EFFICACY OF STUMP PRESSURES iN MONITORING OF CEREBRAL PERFUSION DURING CAROTID ENDARTERECTOMY

The most frequent way of establishing an adequate cerebral perfusion during temporary clamping in carotid endarte­ rectomy, is the use of indwelling shunts. Although some investigators avoid using shunts, options also include selec­ tive and routine shunting. in this report we present the results of our series, in which we have preferred selective shunting. 281 carotid endarterectomies on 271 patients were performed during 1991-2000. The determination of the need for shunting was done on the basis of the presence of an history of CVA in lası 3 months, contrlateral occlusi­ on of !he ınternal carotid artery and a stump pressure less !han 50 mmHg. Of 106 (% 38) patients selected for shun­ ting, 1O (% 3.5) had a stroke and 7 (%2.49) cases resulted in death. Our results reveal that carotid endarterectomy can be safely done with acceptable morbidity and mortality rates if the basic rules are obided by.