Abstract
We examined values of jugular bulb venous oxygen saturation (SjO2) and regional oxygen saturation (rSO2) in addition to electroencephalogram (EEG) monitoring to detect cerebral ischemia during carotid clamping in patients undergoing carotid endarterectomy (CEA). We summarize our finding based on a consecutive series of 10 patients. Six patients had unilateral lesion, and the remaining 4 patients had bilateral lesion or tandem lesion. We encountered cerebral ischemia, which was defined by EEG slowing, during carotid clamping in 2 patients. These patients demonstrated a concomitant decrease in rSO2 to 64% and 52%, respectively: a 10% decrease compared to the pre-clamping baseline in both patients. Contrarily, the SjO2 was maintained at almost the same level with that of pre-clamping. These results suggest that SjO2 is not sufficiently sensitive to detect cerebral ischemia during CEA. Continuous monitoring of rSO2 is adequately sensitive to detect cerebral ischemia, and 10% decrease in rSO2 may indicate cerebral ischemia.
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