A Comparison of Computerized EEG with Internal Carotid Artery Stump Pressure for Detection of Ischemia During Carotid Endarterectomy

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Abstract
Previous investigations appear to indicate that an ischemic EEG is not observed during carotid cross-clamping when the stump pressure is ≥60 mm Hg. In this report of 124 carotid endarterectomies (CEA) performed with selective shunting based on computerized EEG (CEEG), we compared the CEEG and this previously established critical stump pressure level of 60 mm Hg as methods of detecting cerebral ischemia during carotid clamping. A significant association between stump pressure and CEEG findings during clamping existed (p p <0.001). In contrast, for stump pressure, a correlation with the neurologic exam was not found. Compared to CEEG, these results appear to indicate that a critical stump pressure of 60 mm Hg is a sensitive but not specific indicator for the placement of a shunt selectively during CEA. The combined use of these two monitors should lead to reliable shunt selection, especially when stump pressure is <60 mm Hg.

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