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Published on: May 9, 2013
Intraoperative Cerebral Oxygenation and Early Cognitive Functions in Eversion Versus Modified Eversion Carotid
Fevzi Ayyıldız1, Tünay Kurtoğlu2, Selim Durmaz2
1Department of Cardiovascular Surgery, Afyonkarahisar State Hospital, Orhangazi, Türkiye.
Background:
This study aimed to compare eversion carotid endarterectomy (e-CEA) and modified eversion carotid endarterectomy (me-CEA) techniques in terms of intraoperative cerebral oxygenation and early postoperative neurocognitive outcomes.
Methods:
In this prospective observational cohort study, 58 consecutive patients scheduled for carotid endarterectomy between February 2024 and July 2025 were assessed for eligibility. A total of 41 patients were enrolled in the study. All patients were operated under general anesthesia. Cerebral oxygenation was assessed using near-infrared spectroscopy-based regional cerebral oxygen saturation (rSO2). Mean arterial pressure (MAP) and rSO2 were recorded before, during, and after the clamping of the carotid arteries. Cognitive functions were assessed by the Mini-Mental State Examination (MMSE) test administered on the day before the surgery and on the postoperative second and tenth days.
Results:
The mean age was 69.54 ± 8.31 years, and 90.2% of the patients were male. Of the study population, 48.8% (n = 20) underwent e-CEA and 51.2% (n = 21) underwent me-CEA. The mean clamp time was 21.35 minutes for e-CEA and 15.76 minutes for me-CEA (P < 0.001). MAP recorded in the postclamp period was significantly higher in the e-CEA patients (P = 0.033). No significant difference was found between the groups regarding the change of ipsilateral rSO2 after clamping (P = 0.295). Comparison of MMSE scores across the assessment time points showed no significant difference within either group (e-CEA:P = 0.084; me-CEA:P = 0.051).
Conclusion:
Although the me-CEA technique allowed shorter clamp time than e-CEA, it demonstrated similar outcomes in terms of cerebral oxygenation and early postoperative cognitive function.
