Evaluation of the Correlation Between Carotid Stump Pressure and Interhemispheric rSO2 Asymmetry in Awake Carotid Endarterectomy: A Prospective Cohort Study

What this Trial Is About

This research aims to better understand how well the brain receives blood and oxygen during awake carotid endarterectomy (CEA), a surgery to prevent strokes in people with narrowed carotid arteries. The study focuses on the relationship between carotid stump pressure (SP), a pressure measurement taken during surgery, and differences in brain oxygen levels between the two sides of the brain, measured by near-infrared spectroscopy (NIRS). This observational study involves patients undergoing awake CEA under regional anesthesia at a single center. During the surgery, blood flow in the carotid artery is temporarily blocked, and brain oxygen levels in both hemispheres are monitored before and three minutes after this clamping using NIRS. Carotid stump pressure is also measured at that time. Patients will be grouped based on whether their brain oxygen level difference between hemispheres is greater than 10% or not. Researchers will analyze how stump pressure relates to this asymmetry, as well as other patient and surgical factors. Participants will undergo continuous brain oxygen monitoring and carotid stump pressure measurement during surgery. Data will be collected before and after clamping to evaluate oxygen differences and pressure values. Additional assessments include heart rate, blood pressure, oxygen levels in blood, and monitoring for surgical complications up to 30 days after surgery. The main outcome is the difference in stump pressure between patients with and without significant brain oxygen asymmetry. This study may help improve brain monitoring during CEA to protect patients from ischemic injury.

Correlation Between Carotid Stump Pressure and Interhemispheric rSO₂ Asymmetry During Awake Carotid Endarterectomy