Transcranial Doppler Intraoperative Monitoring during Carotid Endarterectomy: Experience with Regional or General Anesthesia,with and without Shunting |
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| Authors: | Rafik Ghali Ettore G. Palazzo Dirk I. Rodriguez Michael Zammit Dennis L. Loudenback R. Patrick DeMuth Merrill P. Spencer Lester R. Sauvage |
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| Affiliation: | (1) Hope Heart Institute, the Providence Medical Center, Seattle, WA, US;(2) Department of Surgery, University of Washington School of Medicine, Seattle, WA, US |
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| Abstract: | p = 0.05). There was no significant difference when particulate and air microemboli were compared. During surgery TCD identified residual flow of less than 40% in the MCA in 17 patients (18.8%). TCD also identified hyperperfusion in two patients, shunt abnormalities in three patients, and influenced postop treatment in four patients, one of whom was returned to surgery. TCD is an important tool for identifying patients who would benefit from a shunt, preventing hyperperfusion, identifying postop emboli, and detecting technical errors. |
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