Compression of the carotid artery. Evaluation of its prognostic significance before endarterectomy of the carotid artery.

Abstract

CAROTID artery compression as an aid in evaluating vascular tolerance and collateral cerebral circulation is often used prior to the surgical treatment of intracranial aneurysms. Although the test is also performed to determine a diagnosis of occlusive forms of cerebral vascular insufficiency, 1,2 it has been avoided in patients with suspected atheromatous plaques of the extracranial carotid arteries. Embolization from the atheromatous lesion or aggravation of the cerebral ischemia due to the stenosed artery as result of the manipulation are the apparent restrictions. However, in spite of these considerations, the test of carotid compression is a valuable adjunct not only to the diagnosis of carotid or vertebrobasilar artery disease, 3 but also to the presurgical preparation of these patients. 4 In our experience, we found the test useful in treating these conditions. The response to the test aids the surgeon in determining the need for adjunctive devices in making the