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The collateral hemispheric systolic pressure.

W Gee, H A Kaupp, K M McDonald

    Archives of Surgery (Chicago, Ill. : 1960)
    |August 1, 1983
    PubMed
    Summary
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    This study found that collateral hemispheric systolic pressure during carotid endarterectomy depends on the opposite carotid artery's condition and central blood pressure. Formulas were derived to ensure adequate pressure for brain integrity.

    Area of Science:

    • Neurosurgery
    • Vascular Surgery
    • Neurology

    Background:

    • Carotid endarterectomy is a common procedure to prevent stroke.
    • Maintaining adequate cerebral blood flow during surgery is crucial for preventing neurological deficits.
    • Assessing collateral circulation is vital for patient safety during carotid interventions.

    Purpose of the Study:

    • To develop predictive formulas for collateral hemispheric systolic pressure.
    • To determine the relationship between central blood pressure, contralateral carotid artery status, and collateral pressure.
    • To establish criteria for adequate collateral pressure to ensure hemispheric integrity during and after carotid occlusion.

    Main Methods:

    • Obtained calibrated blood pressure tracings during 385 carotid endarterectomies.

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  • Measured pressures from the distal common carotid artery with external carotid artery occlusion.
  • Recorded continuous pressures with and without proximal common carotid clamp occlusion.

    • Main Results:

    • Developed distinct formulas for patients with severe contralateral carotid stenosis/occlusion (n=101) and those without (n=284).
    • Demonstrated that collateral hemispheric systolic pressure is influenced by the contralateral carotid artery's condition and central blood pressure.
    • Established a method to demarcate the lowest adequate collateral hemispheric systolic pressure.

    Conclusions:

    • Collateral hemispheric pressure is significantly influenced by the contralateral carotid artery's status.
    • Derived formulas provide a basis for assessing the adequacy of collateral circulation during carotid surgery.
    • These findings aid in optimizing patient management to prevent perioperative stroke.