Cerebral Blood Flow during Carotid Endarterectomy

Author:

WALTZ ARTHUR G.1,SUNDT THORALF M.1,MICHENFELDER JOHN D.1

Affiliation:

1. From the Mayo Clinic and Mayo Foundation, Rochester, Minnesota.

Abstract

Cerebral blood flow (CBF) was measured during 28 carotid endarterectomies in 25 patients, by injection of 133 Xe into the exposed internal carotid artery (ICA). Twenty-three patients had episodic cerebral or retinal ischemia and five had neurologic deficits before operation. Initial CBF values were variable. Increases of Pa Co Co2 caused CBF to increase in four of six patients, to increase slightly in one, and to decrease in one. In each of 19 procedures, CBF decreased during surgical occlusion of the ICA, 11 times to less than 30 ml/100 g/min, but absence of postoperative worsening indicated that decreased ICA blood flow is not a major risk of the procedure; embolization from the site of operation may be a greater threat to the patient. CBF increased after 14 endarterectomies, perhaps due to failure of autoregulation or to reactive hyperemia. Measurements of jugular PV o o2 and lactate concentration were of little value.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Reference21 articles.

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2. Effect of CO., and systemic hypertension on downstream cerebral arterial pressure during carotid endarterectomy;Surgery,1970

3. Jugular venous oxygen saturation as an index of adequacy of cerebral oxygenation;Surgery,1967

4. Effect of blood pressure on blood flow in ischemic and in nonischemic cerebral cortex: The phenomena of autoregulation and luxury perfusion

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