Perioperative Monitoring in Carotid Surgery: Methods, Limits, and Results Long-Term Results in Carotid Surgery

ISBN-13: 9783642959929 / Angielski / Miękka / 2012 / 202 str.

Svante Horsch; K. Ktenidis

Opis

The efficiency of carotid surgery on an asymptomatic carotid artery stenosis and its superiority to conservative treatment was clearly demonstrated in the ACAS study. The stroke risk over a five year follow-up period could be reduced by 55 % and the combined stroke and mortality rate was shown to be a mere 2. 3 %. The efficacy of surgical treatment in also reducing stroke rates in the case of a symptomatic carotid stenosis was proven in the NASCET and ECTS prospective randomized studies. Of extreme importance in these procedures is, however, precise quality control and quality assessment. This is presently a topic of tremendous interest in reconstructive vascular surgery and is constantly being discussed in specialist circles and beyond. Documentation and the possibility of accurate reconstruction of the intraoperative situation are in high demand. Perioperative monitoring of neurological function, particularly the monitoring during carotid surgery, are the aspects underlying constant revision and reassessment to ensure quality control and assurance of a negligeable mortality and morbidity rate.The aim of this book is to discuss the presently available perioperative control methods, examinations, and quality assessments, and the critical consideration of these. We would like to express our thanks to all authors who helped achieve the sense and aim of this book. A special word of thanks to Dr. Kerstin Simons (assistant surgeon) for assisting in the editing of the numerous presentations in this book. Particularly we thank Dr.

Spis treści

I Perioperative protection.- Perioperative protection during carotid surgery on the part of the vascular surgeon.- Perioperative protective procedures in carotid endarterectomy on the part of the anaesthesiologist.- Perioperative monitoring of cerebral tissue oxygenation.- II Cerebral monitoring methods.- Electroencephalography: recording technique, pathophysiological comments, intraoperative monitoring.- Monitoring of somatosensory evoked potentials in carotid artery surgery.- Internal carotid artery back pressure to determine shunt requirement.- Measurement of regional cerebral oxygen saturation.- Postoperative evaluation of blood viscoelasticity response during carotid endarterectomy — considerable consequences for intraoperative management?.- Scintigraphic methods (PET, SPECT) to assess disturbances of the cerebral function before and after carotid endarterectomy (CEA).- III Intraoperative control methods.- Regional anesthesia in carotid surgery: technique and results.- Perioperative results of carotid endarterectomy with cervical epidural anesthesia.- Local anaesthesia and intraoperative quality control in carotid surgery.- Intraoperative angiography in carotid surgery.- IV Intraoperative ICBP, EEG, and SEP monitoring.- Intraoperative electroencephalography (EEG) monitoring and clinical outcome in carotid surgery.- ICBP in comparison to the intraoperative EEG monitoring.- Internal carotid back pressure versus somatosensory evoked potentials to determine shunt requirement.- Intraoperative monitoring during carotid endarterectomy: SEP versus EEG monitoring.- V Intraoperative Transcranial Doppler sonography and oxymetry.- Transcranial Doppler sonography and internal carotid back pressure during carotid surgery: value, limits and results in comparison to somatosensory evoked potentials.- Use of EEG and TCD for assessment of brain function during operations on carotid artery.- Intraoperative monitoring in carotid surgery: transcranial Doppler versus somatosensory evoked potential method.- Transcranial cerebral oxymetry versus jugular venous oxygen saturation.- Transcranial cerebral oxymetry (TCO): a valid monitoring method during carotid surgery?.- VI Short- and long-term results after carotid surgery.- Polytetrafluoroethylene (PTFE) interposition graft in carotid surgery: indications and late results.- Exclusive PTFE patch angioplasty after conventional carotid endarterectomy: short- and long-term results.- Dacron versus Polyurethane (PUR) patch angioplasty in carotid surgery.- Eversion versus conventional carotid endarterectomy.- VII Short- and long-term results after carotid surgery.- Lesions of the aortic arch branches: long-term results after surgical procedures.- Operative results after reconstruction of extracranial carotid artery aneurysms (ECAA).- Carotid surgery before vertebral artery reconstruction: long-term results (1998–1994).- Ex vivo quantification of carotid stenoses: evaluation of eversion endarterectomy specimen.- Consensus conference on perioperative monitoring.