TRANSCRANIAL DOPPLER MONITORING DURING CA ROTID ENDARTERECTOMY

We describe our method of transcranial Doppler (TCD) monitoring during carotid endarterectomy (CE) procedures. During a period of 35 months we performed 257 CE with TCD monitoring. Critical flow values during c rossclamping of the internal carotid artery (ICA) and the necessity of insertion of an intraluminal shunt were taken in consideration with r egard to the choice of surgical procedure: TEA (with or without patchi ng) or eversion endarterectomy. The critical flow values were around 1 0-15 cm/s, no pulsatility signs were detected. Further advantages of t he TCD monitoring are: detection of microemboli, control of the potent ial collateralisation of the external carotid artery and the control o f efficacy and accurate positioning of the intraluminal shunt. We comm ent our results of cerebral monitoring and consider it as a useful too l for optimizing the postoperative results of carotid surgery.