Clinical Reports

Carotid Endarterectomy Clinical Reports and Abstracts

This section is intended to provide you clinical reports for the INVOS Cerebral Oximeter.
We will update this section with abstracts and other Clinical Reports, as they become available.

A link to the document is provided when available. These links may take you to
another site such as PubMed.

Carotid Endarterectomy

Mille T, Tachimiri ME, Klersy C, Ticozzelli G, Bellinzona G, Blangetti I, Pirrelli S, Lovotti M,
Odero A. Near infrared spectroscopy monitoring during carotid endarterectomy: Which threshold
value is critical? Eur J Vasc Endovasc Surg 2004;27:646-650. [Abstract] [PubMed]

Sehic A, Thomas MH. Cerebral oximetry during carotid endarterectomy: signal failure resulting
from large frontal sinus defect. J Cardiothorac Vasc Anesth 2000;14:444-446. [Case Report]

Sills AK, Dalrymple S, Hamm W. Transcranial cerebral oximetry as a non-invasive monitor of
cerebral perfusion during carotid endarterectomy. Presented at the American Association of
Neurological Surgeons Annual Meeting, April 10-12, 2000, San Francisco, California, Article ID:
14779.* [Abstract]

McKinsey JF, Davidovitch R, Gewertz BL. Intraoperative monitoring for cerebral ischemia during
carotid endarterectomy (CEA). In: Ellis J, Roizen M (eds.) Problems in Anesthesia
1999;11(2):193-206

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Eur J Vasc Endovasc Surg. 2004 Jun;27(6):646-50.

Near infrared spectroscopy monitoring during carotid
endarterectomy: which threshold value is critical?

Mille T, Tachimiri ME, Klersy C, Ticozzelli G, Bellinzona G, Blangetti I,
Pirrelli S, Lovotti M, Odero A.

Operative Unit of Clinical Neurophysiology, Neurosurgery Division, Department
of Surgery, IRCCS Policlinico S.Matteo, Pavia, Italy.

OBJECTIVES: Retrospectively to verify which decreasing percentage in regional
oxygen saturation (rSO(2)) identified patients with good collateralisation during
carotid artery cross clamp. MATERIALS AND METHODS: During 594
endarterectomies under general anaesthesia the decreasing percentage from
preclamp value to value detected in the first 2 min after clamping the CCA and/or
ICA was calculated in real time. No temporary shunt was placed in any case.
ROC analysis was performed to determine the optimal cut-off for rSO(2) decrease
to identify the occurrence of neurological complications. RESULTS: A cut-off of
11.7% was identified as optimal. Sensitivity and specificity were 75% (95% CI
71-78) and 77% (95% CI 74-80), respectively. The cut-off of 20% had a lower
sensitivity (30%) and a higher specificity (98%) to identify patients with
complications, with positive and negative predictive value of 37 and 98%,
respectively. CONCLUSIONS: The study suggest that a relative decrease in
rSO(2) of <20% from preclamp to early cross clamp value has a high negative
predictive value, i.e. if rSO(2) does non decrease more than 20%, ischemia by
hypoperfusion is unlikely and a shunt should not be necessary. Moreover, a
relative decrease >20% may not always indicate intraoperative neurological
complications.

PMID: 15121117 [PubMed - indexed for MEDLINE]

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