The Use of Preoperative Transcranial Doppler Variables to Predict Which Patients do Not Need a Shunt During Carotid Endarterectomy

Autor: A.C. van Huffelen, Gerhard Henk Visser, Bert C. Eikelboom, George H. Wieneke
Přispěvatelé: Neurology
Rok vydání: 2000
Předmět:
Male
Ultrasonography
Doppler
Transcranial
medicine.medical_treatment
Cerebral arteries
Carotid endarterectomy
Postoperative Complications
ICA obstruction
Carotid Stenosis
Intraoperative Complications
Endarterectomy
Medicine(all)
Endarterectomy
Carotid
Electroencephalography
Middle Aged
Collateral circulation
Shunt (medical)
Stroke
Anterior communicating artery
CO2 reactivity
Cerebrovascular Circulation
cardiovascular system
Cardiology
Female
Radiology
Cardiology and Cardiovascular Medicine
Blood Flow Velocity
medicine.medical_specialty
Collateral Circulation
Common-carotid-artery compression test
Preoperative care
Monitoring
Intraoperative
medicine.artery
Internal medicine
Preoperative Care
Pressure
medicine
Humans
Aged
Probability
Chi-Square Distribution
business.industry
Transcranial Doppler
Reproducibility of Results
Endovascular shunt
Carbon Dioxide
Cerebral Arteries
Surgery
business
Forecasting
Zdroj: European Journal of Vascular and Endovascular Surgery, 19, 226-232. W.B. Saunders
ISSN: 1078-5884
DOI: 10.1053/ejvs.1999.1009
Popis: Objectives: to analyse whether preoperative transcranial Doppler (TCD) variables can predict intraoperative shunt requirement. Design and methods: the blood-flow velocity (BFV) in the major basal cerebral arteries was measured preoperatively with TCD, in 178 patients scheduled for CEA. Carotid artery compression and CO2 reactivity tests were also performed. Intraoperative electroencephalography was used to decide whether a shunt was needed. Differences in the probability of shunt requirement between the categories of variables were assessed with crosstabs statistics. Results: preoperative TCD criteria clearly identified a subgroup of 59 patients (33%) who did not require a shunt. In general, these patients appeared to have adequate collateral flow through the anterior communicating artery. In contrast, prediction of the need for a shunt was less reliable. TCD variables could predict the need for a shunt with a probability of only 60%. Conclusions: preoperative TCD can be used to identify patients who do not require a shunt during carotid endarterectomy.
Databáze: OpenAIRE
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