Publications (2)0 Total impact
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ABSTRACT: To determine the collateral supply is sufficiency or not in patients with carotid stenosis. Fifteen consecutive patients with carotid stenosis underwent carotid endarterectomy (CEA). We evaluated the patent collateral pathways through the anterior and posterior communicating arteries or the ophthalmic artery (ACoA; PCoA; OA) with TCD before CEA. A total of 15 subjects were monitored the mean velocity of the ipsilateral middle cerebral artery (mvMCA) by TCD and simultaneously detected stump pressure (SP) after cross clamping carotid artery during the operation. Three subjects patent anterior communicating artery; 5 cases patent posterior communicating artery; 6 of 15 patent OA. SP > or = 50 mm Hg in 8 cases and SP < 50 mm Hg in 7 patients were detected after cross clamping. The decrease of the ipsilateral mvMCA is less than 30% of baseline in 11 cases. Both TCD preoperatively and SP during CEA indicated collateral blood adequately or not in 9 cases. Results of 12 patients evaluated collateral supply by means of SP and mvMCA changes were common. TCD is a useful tool for the evaluation of the sufficiency of collateral circulation in patients with carotid artery severe stenosis, especially monitoring the ipsilateral mvMCA changes during carotid endarterectomy.Zhonghua yi xue za zhi 03/2007; 87(9):611-3.
Article: [Application of cerebral protection to carotid endarterectomy at perioperation, intraoperation, and postoperation].[show abstract] [hide abstract]
ABSTRACT: To evaluate the significance of cerebral protection applied at carotid endarterectomy (CEA) at perioperation, intraoperation, and postoperation. Thirty patients underwent CEA with application of cerebral protection at perioperation, intraoperation, and postoperation in our hospital from January 2002 to August 2005. Perioperative carotid Doppler ultrasound and computed tomography angiography (CTA) were applied in 29 patients and carotid angiography applied in only one patient. The key methods of intraoperative cerebral protection included general anaesthesia, selective shunting, monitoring of transcranial Doppler, and careful manipulation. The methods of postoperative cerebral protection included leaving tracheal cannula and brain ice-bag, maintaining normal blood pressure, and applying dehydrant under guidance by monitoring of transcranial Doppler. Among all the 30 patients, shunts were used in 10 patients (33%), and angioplasty by patch was applied in 17 patients (57%). No cranial nerve-associated complications or death was documented. Application of cerebral protection at CEA at perioperation, intraoperation, and postoperation can effectively prevent the occurance of cranial nerve-associated complications.Zhongguo yi xue ke xue yuan xue bao. Acta Academiae Medicinae Sinicae 03/2007; 29(1):37-9.