Somatosensory evoked potential monitoring during carotid surgery

M. L. Schwartz, T. F. Panetta, B. J. Kaplan, Alan D. Legatt, W. D. Suggs, K. R. Wengerter, M. L. Marin, F. J. Veith

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Controversy exists over the value of intraoperative monitoring and shunting in patients undergoing carotid endarterectomy. Although it is widely believed that contralateral carotid occlusion and previous stroke mandate intraoperative shunting, the susceptibility of these two groups of patients to cerebral ischemia during carotid artery endarterectomy is not well defined. Somatosensory evoked potentials (SSEPs) were monitored in 113 carotid artery endarterectomy patients. Of these, 32 (28.3%) had a previous stroke, 24 (21.2%) had a contralateral carotid occlusion and 33 (29.2%) were diabetic. There were no deaths and only one perioperative stroke (0.9%). Cerebral ischemia occurred in 14 patients (12.4%). Six of these patients had a contralateral carotid occlusion. Some 29 patients (25.7%) were shunted, including 10 with contralateral carotid occlusions that did not have major SSEP changes. In the latter half of the study, 14 patients with contralateral carotid occlusions were selectively shunted (six shunted, eight not shunted) with no neurological complications. Thirty-two patients with prior strokes were selectively shunted (nine shunted, 23 not shunted); of these, one shunted patient undergoing combined carotid artery endarterectomy and coronary artery bypass grafting had a perioperative stroke. Intraoperative monitoring with SSEPs accurately identifies cerebral ischemia secondary to carotid clamping as well as patients requiring shunts. With the use of intraoperative SSEP monitoring, selective shunting may be safely performed in patients with a contralateral carotid occlusion or a previous stroke.

Original languageEnglish (US)
Pages (from-to)77-80
Number of pages4
JournalCardiovascular Surgery
Volume4
Issue number1
DOIs
StatePublished - Feb 1996

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Somatosensory Evoked Potentials
Carotid Endarterectomy
Stroke
Brain Ischemia
Carotid Arteries
Intraoperative Monitoring
Constriction
Coronary Artery Bypass

Keywords

  • Carotid surgery
  • Cerebral ischemia
  • Endarterectomy
  • Evoked potentials

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Surgery

Cite this

Schwartz, M. L., Panetta, T. F., Kaplan, B. J., Legatt, A. D., Suggs, W. D., Wengerter, K. R., ... Veith, F. J. (1996). Somatosensory evoked potential monitoring during carotid surgery. Cardiovascular Surgery, 4(1), 77-80. https://doi.org/10.1016/0967-2109(96)83789-6

Somatosensory evoked potential monitoring during carotid surgery. / Schwartz, M. L.; Panetta, T. F.; Kaplan, B. J.; Legatt, Alan D.; Suggs, W. D.; Wengerter, K. R.; Marin, M. L.; Veith, F. J.

In: Cardiovascular Surgery, Vol. 4, No. 1, 02.1996, p. 77-80.

Research output: Contribution to journalArticle

Schwartz, ML, Panetta, TF, Kaplan, BJ, Legatt, AD, Suggs, WD, Wengerter, KR, Marin, ML & Veith, FJ 1996, 'Somatosensory evoked potential monitoring during carotid surgery', Cardiovascular Surgery, vol. 4, no. 1, pp. 77-80. https://doi.org/10.1016/0967-2109(96)83789-6
Schwartz, M. L. ; Panetta, T. F. ; Kaplan, B. J. ; Legatt, Alan D. ; Suggs, W. D. ; Wengerter, K. R. ; Marin, M. L. ; Veith, F. J. / Somatosensory evoked potential monitoring during carotid surgery. In: Cardiovascular Surgery. 1996 ; Vol. 4, No. 1. pp. 77-80.
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