Perioperative Monitoring in Carotid Surgery

1. Front Matter

   Pages I-IX

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2. Perioperative protection

   1. Perioperative protection during carotid surgery on the part of the vascular surgeon

      • J. R. Allenberg

      Pages 1-2

   2. Perioperative protective procedures in carotid endarterectomy on the part of the anaesthesiologist

      • M. Abel, J. F. Meier

      Pages 3-5

   3. Perioperative monitoring of cerebral tissue oxygenation

      • M. A. Weigand, H. J. Bardenheuer

      Pages 7-18

3. Cerebral monitoring methods

   1. Electroencephalography: recording technique, pathophysiological comments, intraoperative monitoring

      • U. Schauseil-Zipf

      Pages 19-21

   2. Monitoring of somatosensory evoked potentials in carotid artery surgery

      • W. F. Haupt, S. Horsch

      Pages 23-29

   3. Internal carotid artery back pressure to determine shunt requirement

      • W. S. Moore

      Pages 31-35

   4. Measurement of regional cerebral oxygen saturation

      • M. Holzschuh, C. Woertgen, A. Brawanski

      Pages 37-42

   5. Postoperative evaluation of blood viscoelasticity response during carotid endarterectomy — considerable consequences for intraoperative management?

      • M. Hold

      Pages 43-53

   6. Scintigraphic methods (PET, SPECT) to assess disturbances of the cerebral function before and after carotid endarterectomy (CEA)

      • M. Grond

      Pages 55-59

4. Intraoperative control methods

   1. Regional anesthesia in carotid surgery: technique and results

      • A. M. Imparato, C. B. Rockman, T. S. Riles, M. Gold, P. J. Lamparello, G. Giangola et al.

      Pages 61-67

   2. Perioperative results of carotid endarterectomy with cervical epidural anesthesia

      • B. Habozit, J. P. Derosier, A. Gaillard

      Pages 69-74

   3. Local anesthesia and intraoperative quality control in carotid surgery

      • G. W. Hagmüller, G. Hastermann, H. Ptakovsky

      Pages 75-79

   4. Intraoperative angiography in carotid surgery

      • Klaus Balzer, J. D. Gruss, W. Lang

      Pages 81-90

5. Intraoperative ICBP, EEG, and SEP monitoring

   1. Intraoperative electroencephalography (EEG) monitoring and clinical outcome in carotid surgery

      • W. Sandmann

      Pages 91-92

   2. ICBP in comparison to the intraoperative EEG monitoring

      • H. Loeprecht

      Pages 93-94

   3. Internal carotid back pressure versus somatosensory evoked potentials to determine shunt requirement

      • H. Schweiger, R. Rümenapf

      Pages 95-97

   4. Intraoperative monitoring during carotid endarterectomy: SEP versus EEG monitoring

      • E. Fava, F. Lang, P. L. Vandone, E. Bortolani, M. Schieppati

      Pages 99-103

6. Intraoperative Transcranial Doppler sonography and oxymetry

   1. Transcranial Doppler sonography and internal carotid back pressure during carotid surgery: value, limits and results in comparison to somatosensory evoked potentials

      • M. Dinkel, H. Langer, P. Huber, H. Schweiger, W. Lang

      Pages 105-110

   2. Use of EEG and TCD for assessment of brain function during operations on carotid artery

      • R. G. A. Ackerstaff, F. L. Moll

      Pages 111-120

The efficiency of carotid surgery on an asymptomatic carotid artery stenosis and its superiority to conservative treatment was clearly demonstrated in the ACAS study. The stroke risk over a five year follow-up period could be reduced by 55 % and the combined stroke and mortality rate was shown to be a mere 2. 3 %. The efficacy of surgical treatment in also reducing stroke rates in the case of a symptomatic carotid stenosis was proven in the NASCET and ECTS prospective randomized studies. Of extreme importance in these procedures is, however, precise quality control and quality assessment. This is presently a topic of tremendous interest in reconstructive vascular surgery and is constantly being discussed in specialist circles and beyond. Documentation and the possibility of accurate reconstruction of the intraoperative situation are in high demand. Perioperative monitoring of neurological function, particularly the monitoring during carotid surgery, are the aspects underlying constant revision and reassessment to ensure quality control and assurance of a negligeable mortality and morbidity rate. The aim of this book is to discuss the presently available perioperative control methods, examinations, and quality assessments, and the critical consideration of these. We would like to express our thanks to all authors who helped achieve the sense and aim of this book. A special word of thanks to Dr. Kerstin Simons (assistant surgeon) for assisting in the editing of the numerous presentations in this book. Particularly we thank Dr.

• carotid surgery
• control methods
• perioperative monitoring
• stroke
• surgery
• vascular surgery

• Klinik für Allgemeinchirurgie - Gefäßchirurgie und Traumatologie, Krankenhaus Porz am Rhein Akademisches Lehrkrankenhaus der Universität zu Köln, Köln, Deutschland

  Svante Horsch, Kiriakos Ktenidis

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