11. 'Two is better than one'? Simultaneous monitoring of multichannel somatosensory evoked potentials and electroencephalogram during carotid endarterectomy

Autor: M. Piccininni, F. Passuello, A. Lenzi, Leonardo Ercolini, D. Battista, Gaetano Zaccara, S. Colon, E. Del Sordo, E. Barbanti, R. Mazzeo, Massimo Cincotta, P. Frosini, A. Ragazzoni, E. Sirabella, Alessandra Borgheresi, Emiliano Chisci, A. Molisso, N. Cellai, L. Tramacere, P. Vanni, Stefano Michelagnoli, C. Cardinali
Rok vydání: 2013
Předmět:
Zdroj: Clinical Neurophysiology. 124:e191
ISSN: 1388-2457
DOI: 10.1016/j.clinph.2013.06.038
Popis: In carotid endarterectomy (CEA), EEG and somatosensory evoked potentials (SEPs) are the most commonly used monitoring techniques to prevent perioperative stroke. However, which of these methods is the most appropriate is not definitely established. Here we evaluated retrospectively simultaneous EEG and SEP recordings. Our CEA series was analyzed backward to identify 30 patients requiring carotid shunt. Shunting was performed in 7.1% of 420 consecutive CEA over a 20-month period. All CEAs were continuously monitored by multi-channel EEG and SEPs before, during and 20 min following carotid cross-clamping. The most reliable SEP criterion for shunting was marked amplitude reduction or disappearance of cortical components (N20, P25), usually associated or preceded by a unilateral or bilateral suppression of EEG activity. Three of the shunted patients had minor postoperative neurological deficits. Amongst the 390 non-shunted patients, 1 had a postoperative ischemic stroke and 1 one had a cerebral hemorrhage. Findings confirm that SEPs are less sensitive but more specific than EEG for the detection of cerebral ischemia in CEA. The number of shunting and major ischemic events in non-shunted patients associated to simultaneous EEG and SEP monitoring was lower than those commonly reported in the literature of CEA.
Databáze: OpenAIRE
Externí odkaz: