Comparing near-infrared spectroscopy monitoring and stump pressure measurement to estimate the need for shunting during carotid artery endarterectomy

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