Intraoperative neurophysiological monitoring during urgent surgical extracranial internal carotid artery recanalization
Jazyk angličtina Země Nizozemsko Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
35227592
DOI
10.1016/j.clinph.2022.01.135
PII: S1388-2457(22)00162-6
Knihovny.cz E-zdroje
- Klíčová slova
- Intraoperative monitoring, Ischemic stroke, Selective shunting, Somatosensory evoked potentials, Urgent recanalization,
- MeSH
- arteria carotis interna chirurgie MeSH
- intraoperační neurofyziologická monitorace * MeSH
- ischemie mozku * prevence a kontrola MeSH
- lidé MeSH
- nemoci arterie carotis * chirurgie MeSH
- prospektivní studie MeSH
- somatosenzorické evokované potenciály fyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVE: The clinical outcome of surgical extracranial internal carotid artery (eICA) recanalization may be adversely affected by intraoperative ischemia. Median nerve somatosensory evoked potential (SEP) amplitude correlates well with cerebral blood flow. Our study presents the value of intraoperative SEP and selective shunting in the prevention of intraoperative ischemia development during urgent eICA recanalization. METHODS: Prospective recruitment of patients with acute unilateral eICA occlusion. All underwent surgical recanalization with intraoperative monitoring of scalp median SEPs. Preoperative clinical findings, cerebral collaterals, and 3 month functional outcome were evaluated. RESULTS: The cohort consisted of 33 patients. Intraoperative SEP amplitude decreased significantly in 6 (18.2%). An intraluminal shunt was inserted twice (6.1%), surgical complications occurred in 6 (18.2%), intracerebral hemorrhage was not found. Favorable outcome 3 months after surgery according to the modified Rankin scale (mRS 0-2) was achieved in 28 (84.8%), 3 patients died (9.1%). CONCLUSIONS: Intraoperative SEP during urgent eICA recanalization seems to be beneficial. Thanks to the effective measure based on the intraoperative SEP changes, the clinical outcome in four(12.1%) could be positively affected. SIGNIFICANCE: The results suggest that selective shunting based on intraoperative median SEPs may prevent intraoperative ischemia and may improve overall outcome of urgent eICA recanalization.
Department of Neurology České Budějovice Hospital Czech Republic
Department of Neurosurgery České Budějovice Hospital Czech Republic
Department of Radiology České Budějovice Hospital Czech Republic
Citace poskytuje Crossref.org
