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Related Experiment Video

Updated: Feb 22, 2026

Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
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Risk factors for a decrease in somatosensory evoked potential amplitude during carotid endarterectomy with routine

Takahiro Yamauchi1, Motoki Inaji1, Daisu Abe1

  • 1Institute of Science Tokyo, Department of Neurosurgery, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|February 20, 2026
PubMed
Summary
This summary is machine-generated.

Identifying patients at risk for stroke reduction surgery complications is key. Symptomatic disease, severe contralateral stenosis, and A1 segment hypoplasia predict somatosensory evoked potential (SSEP) decreases during carotid endarterectomy (CEA).

Keywords:
Carotid endarterectomyInternal carotid artery stenosisIschemiaShuntSomatosensory evoked potential

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Area of Science:

  • Neurology
  • Vascular Surgery
  • Neurophysiology

Background:

  • Carotid endarterectomy (CEA) is a crucial stroke prevention surgery.
  • Cerebral hypoperfusion during carotid artery clamping is a significant risk.
  • Somatosensory evoked potentials (SSEPs) monitor for hypoperfusion, but predictors of amplitude decrease are unclear.

Purpose of the Study:

  • To identify risk factors for substantial SSEP amplitude decreases during CEA with routine shunting.
  • To characterize patients at increased risk for intraoperative cerebral hypoperfusion.

Main Methods:

  • Retrospective analysis of 467 patients undergoing CEA with routine shunting and SSEP monitoring (2008-2022).
  • Defined significant SSEP amplitude decrease as ≥50% reduction in N20-P25 amplitude.
  • Evaluated associations between SSEP changes and clinical/imaging findings using univariable and multivariable analyses.

Main Results:

  • 18.8% of patients experienced a significant SSEP amplitude decrease.
  • Independent risk factors included symptomatic disease, severe contralateral carotid stenosis (≥70% or occlusion), and A1 segment hypoplasia.
  • Beta-blocker use was associated with a reduced risk of SSEP amplitude decreases.

Conclusions:

  • Preoperative identification of at-risk patients is possible.
  • Factors like symptomatic disease, contralateral stenosis severity, and A1 segment morphology predict SSEP changes.
  • This assessment can help mitigate neurological complications during CEA.