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Use of multi-modality intraoperative monitoring during carotid endarterectomy surgery: a case study
Brigitte N Malek1, Cindy A Mohrhaus, Ateer K Sheth
1Clinical Neurodiagnostics, LLC, Atlanta, Georgia, USA.
Insights
Carotid endarterectomy (CEA) surgery can be risky. Continuous EEG and somatosensory evoked potential (SSEP) monitoring effectively detect cerebral ischemic changes during CEA, improving patient safety.
Area of Science:
- Neurology
- Neurosurgery
- Medical Monitoring
Background:
- Carotid artery stenosis is a significant risk factor for stroke and TIA in the US.
- Carotid endarterectomy (CEA) is an effective treatment but carries inherent surgical risks.
- Intraoperative monitoring techniques are employed to mitigate CEA complications.
Observation:
- This case review examines the utility of continuous electroencephalography (EEG) and somatosensory evoked potential (SSEP) monitoring during CEA.
- These monitoring methods aim to detect cerebral ischemic events in real-time.
Findings:
- Continuous EEG and SSEP monitoring are effective tools for identifying cerebral ischemic changes during CEA surgery.
- The study demonstrates the feasibility and utility of these monitoring techniques in clinical practice.
Implications:
- Implementing EEG and SSEP monitoring during CEA can potentially reduce surgical morbidity and improve patient outcomes.
- This approach enhances the safety profile of carotid endarterectomy for patients at risk of stroke.
Abstract:
Carotid artery stenosis is a major risk factor leading to cerebral infarct, transient ischemic attack (TIA), and ischemic stroke in the United States. While carotid endarterectomy (CEA) surgery has been established as an effective treatment option for severe carotid artery stenosis, many risks remain inherent in performing this procedure. Surgeons will often utilize various intraoperative monitoring techniques in an effort to reduce surgical complications and morbidity. The usefulness of continuous EEG and somatosensory evoked potential (SSEP) monitoring during CEA surgery has been examined by many groups over the last couple decades. The following case review clearly proves that such monitoring is an effective tool in the detection of cerebral ischemic changes and is therefore feasible in CEA surgery.