Pre-occlusion and Stump Pressure of the Internal Carotid Artery in Carotid Endarterectomy / 中国微创外科杂志

ABSTRACT

Objective To investigate the value of the pre-occusion and stump pressure(SP)of the internal carotid artery in carotid endarterectomy(CEA).Methods During Januray 2007 to January 2009,12 patients with carotid arterial stenosis underwent CEA in our deparment.With cervical plexus block,we performed pre-occlusion test and measured the stump pressure(SP)by using vascular shunt selectively.The patients were monitored with clear consciousness during the whole procedure of CEA.The data of postoperative complications and results of pre-occlusion and SP as well as the follow-up were analyzed afterwards.Results During the operaion,three patients had transient increase of heart rate and blood pressure.The lowest SP was detected in two patients,who had moderate or severe stenosis of the contralateral carotid artery complicated with lesions in the vertebral basilar artery.Two patients showed positive results in pre-occusion test,and vascular shunt was used in four cases.After the operaion,one patients developed hyperperfusion syndrome.Nine patients showed improvement of symptoms of dizziness and decreased eyesight.This series were followed up for a mean of 11 months(ranged from 1 to 26 months).During the period,two of the patients showed re-stenosis of the carotid artery;none of them had cerebral infarction.Conclusions Cervical plexus block combined with pre-occusion test ensures the safty and effectiveness of minimally invasive carotid endarterectomy.We recommend selective vascular shunt according to the results of pre-occlusion test,SP,and the severity of the lesions in the contralateral carotid artery and vertebral basilar artery.