Thiopental sodium cerebral protection during carotid endarterectomy: Perioperative disease and death

Frawley, John E.; Hicks, Richard G.; Horton, David; Gray, Laura J.; Niesche, John W.; Matheson, J. M.

doi:10.1016/s0741-5214(94)70049-4

Cited by 27 publications

(21 citation statements)

References 16 publications

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“…[2][3][4] This technique eliminates intra-operative ischaemic stroke and complications from intraluminal shunting, and allows sufficient time for meticulous clearing of the endarterectomy site and for arteriotomy closure. [2][3][4] This technique eliminates intra-operative ischaemic stroke and complications from intraluminal shunting, and allows sufficient time for meticulous clearing of the endarterectomy site and for arteriotomy closure.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Peri‐operative Stroke Complicating Carotid Endarterectomy: Selective Analysis of a Prospective Audit of 1000 Consecutive Operations

Frawley

Hicks

2000

Aust. N.Z. J. Surg.

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Section: Discussionmentioning

confidence: 99%

“…[2][3][4] As part of this it was essential that the causes of peri-operative stroke were accurately identified and recorded. [2][3][4] As part of this it was essential that the causes of peri-operative stroke were accurately identified and recorded.…”

Section: Prospective Auditmentioning

confidence: 99%

Risk Factors for Peri‐operative Stroke Complicating Carotid Endarterectomy: Selective Analysis of a Prospective Audit of 1000 Consecutive Operations

Frawley

Hicks

2000

Aust. N.Z. J. Surg.

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“…Previous studies indicated a higher incidence of electroencephalography (EEG) changes and shunt use in patients with contralateral carotid artery occlusion or critical stenosis. 30 It is very clear that brain protection under general anesthesia is very important in this patient group. It is known that thiopental use provides a safe cross-clamp time.…”

Section: Discussionmentioning

confidence: 99%

Experience of 352 Carotid Endarterectomy Cases Operated on without Any Shunt and a Technical Modification: Thirty-Day Results

Okur¹,

Akpınar²,

Uyar³

et al. 2013

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The necessity for an indwelling arterial shunt during carotid endarterectomy (CEA) is one of the most widely debated and long-standing controversies in carotid surgery. We developed a modified technique for carotid endarterectomy without using a shunt and have achieved successful results with this procedure. The aim of this study is to present these 352 isolated CEA cases and evaluate the results. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In our clinic, 352 isolated CEA were performed on 320 consecutive patients without using a shunt between 2005 and 2012. In 32 of the cases, bilateral CEA were performed. Among the patients, 36.8 % (n=118) were neurologically asymptomatic, and 63.2 % (n=202) were symptomatic. Complete occlusion was present in the contralateral carotid arteries of 23 patients. All patients were operated on under general anesthesia, and no intraluminal shunts were used. This operative technique is a modification of an eversion carotid endarterectomy in which a longitudinal arteriotomy is begun on the common carotid artery (CCA) and purposely skewed towards the origin of the external carotid artery. The mean crossclamp time in our study was 12±4.62 minutes. R Re es su ul lt ts s: : There was one case of postoperative mortality (0.28%) that was caused by myocardial infarction. We observed 1 (0.28%) case of permanent neurologic deficit, 27 (7.6%) cases of peripheral nerve damage, 4 (1.1%) cases of early postoperative transient neurologic attack, 3 (0.85%) cases of hoarseness and 3 (0.85%) cases of neurocognitive impairment. C Co on nc cl lu us si io on n: : The results indicate that this mini-modified eversion CEA surgery performed without the use of a shunt can be successful for patients with carotid stenosis. K Ke ey y W Wo or rd ds s: : Endarterectomy, carotid; ischemic attack, transient; stroke Ö ÖZ ZE ET T A Am ma aç ç: : Karotis arter endarterektomi (CEA) cerrahisinde şant kullanım gerekliliği, yama kullanımı, eversiyon ve konvansiyonel endarterektomi teknikleri halen tartışılan konulardır. Kliniğimizde CEA operasyonları şant kullanılmadan yapılmaktadır. Yine bu operasyonlarda kliniğimizde geliştirilmiş olan farklı bir arteriyotomi tekniği kullanılmaktadır. Bu çalışmada şant kullanılmadan gerçekleştirilen 352 izole CEA olgusu değerlendirilmiş ve kliniğimizce geliştirilmiş olan tekniğinin tarifi ve erken dönem sonuçları tartışılmıştır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kliniğimizde 2005-2012 yılları arasında 320 hastaya 32'si bilateral olmak üzere, toplam 352 izole CEA operasyonu uygulandı. Hastaların %36,8 (n=118)'i nörolojik olarak asemptomatik, %63,2 (n=202)'si ise semptomatik hastalardan oluşmaktaydı. Tüm hastalar genel anestezi altında ve şant kullanılmadan opere edildi. Endarterektomi, ana karotis arterden eksternal karotis artere longitudinal bir arteriyotomi insizyonu ile gerçekleştirildi. Ortalama kros klemp zamanı 12±4,62 dakika olarak ölçüldü. B Bu ul lg gu ul la ar r: : Genel anestezi altında...

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“…Studies in human subjects show onset of burst suppression with plasma thiopental concentrations of approximately 0.08 to 0.20 mM (Airey et al, 1982;Stanski et al, 1984). The burst suppression EEG pattern is a relevant point of comparison because it is considered by many authors to signal the optimal anesthesia depth for neuroprotection (Frawley et al, 1994;Zaidan et al, 1991; but see also Warner et al, 1996). Burst suppression is also the usual endpoint in barbiturate treatment of refractory status epilepticus (Lowenstein et al, 1988;Van Ness, 1990).…”

Section: Introductionmentioning

confidence: 99%

Barbiturates impair astrocyte glutamate uptake

Swanson

Seid

1998

Glia

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Thiopental sodium cerebral protection during carotid endarterectomy: Perioperative disease and death

Cited by 27 publications

References 16 publications

Risk Factors for Peri‐operative Stroke Complicating Carotid Endarterectomy: Selective Analysis of a Prospective Audit of 1000 Consecutive Operations

Risk Factors for Peri‐operative Stroke Complicating Carotid Endarterectomy: Selective Analysis of a Prospective Audit of 1000 Consecutive Operations

Experience of 352 Carotid Endarterectomy Cases Operated on without Any Shunt and a Technical Modification: Thirty-Day Results

Barbiturates impair astrocyte glutamate uptake

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