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The effect of cerebral oximeter use on the shunt placement concerning carotid endarterectomy surgery


1 Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey
2 Department of Cardiac and Vascular Surgery, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey

Correspondence Address:
Dilek Ceyhan
Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_57_18

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Year : 2019  |  Volume : 22  |  Issue : 2  |  Page : 158-161

 

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Background: During carotid arterial endarterectomy (CAE) surgery, an intraluminal shunt is used to prevent hypoperfusion, which can be caused by a cross-clamping cerebral ischemia. However, routine shunt use is not recommended. Various cerebral monitoring techniques are used to determine the need for shunt placement. In this study, retrospective analysis of data on the efficacy of cerebral oximetry in the decision of shunt use during elective CAE surveys was planned. Materials and Methods: We collected data on 68 patients operated under general anesthesia between December 2016 and December 2017. Patients were evaluated for near infrared spectrometry (NIRS) and stump pressure values and whether shunt was placed or not. Results: Eight (11.7%) patients were shunting. NIRS value after cross-clamping was lower in patients with shunt. Stump pressure values were below 40 mmHg. Conclusions: Cerebral monitoring in elective CAE operations has great importance in determining the necessity of using intraluminal shunt to reduce the complications that may occur.






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1 Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey
2 Department of Cardiac and Vascular Surgery, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey

Correspondence Address:
Dilek Ceyhan
Department of Anesthesiology and Reanimation, Eskisehir Osmangazi University Medical Faculty, Eskisehir 26480
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.ACA_57_18

Rights and Permissions

Background: During carotid arterial endarterectomy (CAE) surgery, an intraluminal shunt is used to prevent hypoperfusion, which can be caused by a cross-clamping cerebral ischemia. However, routine shunt use is not recommended. Various cerebral monitoring techniques are used to determine the need for shunt placement. In this study, retrospective analysis of data on the efficacy of cerebral oximetry in the decision of shunt use during elective CAE surveys was planned. Materials and Methods: We collected data on 68 patients operated under general anesthesia between December 2016 and December 2017. Patients were evaluated for near infrared spectrometry (NIRS) and stump pressure values and whether shunt was placed or not. Results: Eight (11.7%) patients were shunting. NIRS value after cross-clamping was lower in patients with shunt. Stump pressure values were below 40 mmHg. Conclusions: Cerebral monitoring in elective CAE operations has great importance in determining the necessity of using intraluminal shunt to reduce the complications that may occur.






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