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Intraoperative Regional Cerebral Blood Flow During Carotid Endarterectomy

Published online by Cambridge University Press:  18 September 2015

David W. Rowed  and
Miklos I. Vilaghy
David W. Rowed*
Affiliation:
Divisions of Neurosurgery and Neurology, Sunnybrook Medical Centre, University of Toronto
Miklos I. Vilaghy
Affiliation:
Divisions of Neurosurgery and Neurology, Sunnybrook Medical Centre, University of Toronto
*
Division of Neurosurgery, Room 4037, Sunnybrook Medical Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5
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Summary:

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Regional cerebral blood flow (rCBF) during internal carotid artery (ICA) occlusion for endarterectomy can be measured without inconvenience using the probe holder illustrated.

When mean ipsilateral hemispheric CBF exceeds 20 ml/100 gm/min, an intraluminal bypass is not necessary (63% of patients), except in patients with extensive cerebrovascular disease in whom rCBF should also exceed 20 ml/100 gm/min in all areas. ICA “stump” pressure is falsely high in about 20% of patients, and is therefore not a dependable criterion for selecting patients who need shunting.

While intraoperative shunting is capable of restoring pre-occlusion CBF levels, it does not eliminate the risk of intraoperative ischemic neurological deficit of probable embolic origin.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 8 , Issue 3 , August 1981 , pp. 235 - 241
Copyright
Copyright © Canadian Neurological Sciences Federation 1981

References

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