The effect of normotensive arterial pressure on cerebral saturation during carotid endarterectomy

Abstract

Aim: Monitoring of cerebral perfusion during carotid endarterectomy helps to institute early intervention to prevent risk ofischemia during the operation. We aimed to evaluate if the disadvantages of high systemic pressure can be avoided by keepingarterial blood pressure below 150 mmHg during cross-clamping of the internal carotid artery by correlating our findings ofNIRS values with clinical results.Material and Method: This was designed as a prospective study that included elective patients scheduled for an operation ofcarotid artery stenosis under general anesthesia. A total of 60 patients operated on between August and October 2019 wereincluded in the study.Results: Patients' NIRS findings on the right and left hemispheres were analyzed separately to be able to differentiate anypossible changes of NIRS of the cerebral hemisphere ipsilateral to the clamped carotid artery. The analysis of the right and leftNIRS findings in these 60 patients revealed a significant decrease between intubation and incision NIRS values (p=0.008 andp=0.02 respectively).Conclusion: Considering the NIRS findings and clinical observations of the patients in the postoperative period, we think thatICA endarterectomy operations may be safe to perform in a suitable patient group while the systolic arterial blood pressure ismaintained below 150mmHg during cross-clamping