Application and efficacy of induced hypertension and hypotension in carotid endarterectomy
10.3760/cma.j.issn.1007-631X.2018.12.003
- VernacularTitle:诱导性升/降压技术在颈动脉内膜斑块切除术中的应用及疗效
- Author:
Qingjun JIANG
1
;
Jun BAI
;
Xiangguo JI
;
Lefeng QU
;
Wenbo LI
;
Yufeng YAN
;
Dongzhe CHAI
;
Yaolin LIU
;
Qingyong LI
;
Zhongwen CAO
Author Information
1. 海军军医大学附属长征医院血管外科
- Keywords:
Endarterectomy,carotid;
Circle of Willis;
Induced hypertension/hypotension;
Stump pressure
- From:
Chinese Journal of General Surgery
2018;33(12):994-997
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of induced hypotension and hypotension in carotid endarterectomy (CEA).Methods Data of 1 486 patients who underwent CEA in multicenters from Aug 2012 to Aug 2018 were retrospectively analyzed.After screening,a total of 1 448 patients met the inclusion criteria.Induced hypertension and hypotension was used in all thees patients.Results 87.8％ of the patients were with severe carotid stenosis.The average operative time was (51.8 ± 6.1) min,and the internal carotid artery clamping time was (11.4 ± 3.1) min.After induced hypertension,the stump pressure were higher than that before,of which 1 438 (99.3％) were greater than 50 mmHg.Monitoring of EEG oxygen saturation showed that the value of ipsilateral rSO2 was significantly lower than that of the contralateral [(56％ ± 3％) vs.(64％ ± 4％),P ＜ 0.05] before induced hypertension.After induced hypertension and clamp removal,the value of ipsilateral rSO2 was lower than that of the contralateral,but there was not significant difference (all P ＞ 0.05).Perioperative cerebral infarction occurred in 2 cases,ipsilateral cerebral hemorrhage in 1 case,contralateral cerebral hemorrhage in 1 case and myocardial infarction in 2 cases.Connclusion The technique of induced hypotension and hypotension play a temporary role in brain protection for patients undergoing CEA.This study demonstrated the safety and effectiveness of induced hypertension and hypotension technique.
