Journal of vascular surgery
-
Comparative Study
Internal carotid artery flow volume measurement and other intraoperative duplex scanning parameters as predictors of stroke after carotid endarterectomy.
Intraoperative duplex scanning (IDS) after carotid endarterectomy (CEA) has been shown to reliably identify major defects either by significant changes in peak systolic velocities or by B-mode imaging. To evaluate whether IDS could also predict postoperative strokes in technically flawless CEAs, we analyzed several hemodynamic parameters and correlated them with patient outcome. ⋯ IDS is helpful in identifying residual lesions or defects that may contribute to postoperative neurologic deficits. MICAVF <100 mL/min are suggestive of spasm that could lead to thrombus formation and stroke, particularly in the presence of synthetic patches. We suggest that heparin reversal should not be used unless ICA flow rates are >100 mL/min. ICA spasm is short lived in most patients undergoing CEA.
-
Comparative Study
Epidural cooling for the prevention of ischemic injury to the spinal cord during aortic occlusion in a rabbit model: determination of the optimal temperature.
This experiment was designed for the determination of the optimal epidural cooling temperature for the allowance of spinal cord protection with minimal side effects during an aortic occlusion-induced spinal cord ischemia model in rabbits. ⋯ These study results suggest that in rabbits satisfactory spinal cord protection during aortic occlusion can be achieved at moderate regional hypothermia (24 degrees C). Large volume infusion for the achievement of profound hypothermia may cause deleterious effects of increased ICP and is not warranted.