Association of Intraoperative Transcranial Doppler Monitoring Variables With Stroke From Carotid Endarterectomy

Abstract

In CEA, TCD-detected microemboli during dissection and wound closure, > or =90% MCA velocity decrease at cross-clamping, and > or =100% pulsatility index increase at clamp release are associated with operative stroke. In combination with the presence of preoperative cerebral symptoms and > or =70% ipsilateral internal carotid artery stenosis, these 4 TCD monitoring variables reasonably discriminate between patients with and without operative stroke. This supports the use of TCD as a potential intraoperative monitoring modality to alter the surgical technique by enhancing a decrease of the risk of stroke during or immediately after the operation.