[Anesthesia for carotid surgery with clamping under residual carotid pressure control]

Carotid endarterectomy with clamping is performed in 50 patients. Internal carotid artery stump pressure is measured in all cases after clamping at the beginning of the operation. In 35 patients, an increase of systolic pressure is observed which allows a stump pressure more than 70 mmHg in 29 patients. In 15 patients, systolic pressure decreases and a stump pressure more than 70 mmHg is observed in two patients. When the stump pressure is more than 70 mmHg, the clamping is maintained. When the stump pressure is low, the clamping is stopped. A perfusion of Metaraminol increases systolic pressure in all cases: stump pressure is measured again after a second clamping. In 17 cases out of 19, stump pressure increases more than 70 mmHg and the clamping is maintained. In the two cases with a low stump pressure, a shunt is used during intervention.