CEREBRAL MICROEMBOLISM AND ISCHEMIC CHANGES ASSOCIATED WITH CAROTID ENDARTERECTOMY

Purpose: The purpose of this study is to characterize microembolic sig nals (MS) that occur during the various phases of carotid endarterecto my (CEA) and to consider their relationship to postoperative changes o n magnetic resonance imaging (MRI). Methods: This was a retrospective study of 76 patients who underwent 78 carotid endarterectomies at a re ferral center. Perioperative transcranial Doppler monitoring and MRT w ere performed before and after CEA. The types of MS that occurred duri ng phases of surgery were analyzed and compared with MRI changes. Resu lts: We observed a clinical stroke in one patient (1.3%) and ipsilater al small areas of silent ischemic change on seven postoperative MRI st udies (9.0%). In 95% of CEAs, MS were detected. Only those MS observed in the recovery room that occurred at a rate of more than five per 15 minutes were associated with postoperative MRI ischemic changes (p < 0.0001). Conclusions: Ischemic changes on MRI after CEA are related to postoperative MS.