Analysis Of Safety In The Treatment Of Severe Carotid Artery Stenosis By CEA Under Continuous Electroencephalogram Monitoring

Objectives:Through preoperative evaluation of hemodynamics,electrophysiological and imaging before operation,Using eeg monitoring at carotid endarterectomy for severe carotid artery stenosis is compared with electrophysiological monitoring to explore the predictive effect of eeg on insufficient blood supply.Whether the changes of eeg and electrophysiological monitoring were consistent during operation.Through preoperative assessment,to explore the safety and efficacy of carotid endarterectomy under electroencephalogram monitoring in the treatment of patients with severe carotid stenosis,to provide the experience of electroencephalogram monitoring for carotid artery ablation in patients with severe carotid artery stenosis,and provide reliable basis for the promotion of carotid artery endarterectomy and intraoperative monitoring.Methods:A retrospective analysis was conducted of 18 patients with severe carotid stenosis who underwent carotid endarterectomy from March 2016 to February 2019 in Hunan Brain Hospital Department.Hospitalization data including general information collection and past medical historywere collected,preoperative conditions,intraoperative conditions,postoperative conditions,follow-up in 3 months after the operation.Results:1.Complications within 7 days after operation: 18 patients had no death,hemorrhage,ischemic stroke,cranial nerve injury or hyperperfusion injury after CEA surgery.there was 1 case of neck hematoma,which was recovered after conservative treatment.2.18 patients with severe symptomatic carotid stenosis were followed up.vascular recovery was reexamined in 16 cases,1 case developed mild stenosis and 1 case had occlusion in 3 months after operation.The symptom improvement rate was 94.4%.During the monitoring of eeg,ipsilateral slow wave in 4 patients showed increased,which gradually recovered after the restoration of blood flow.18 cases of postoperative mRS score compared with preoperative in 3 month after operation,The change was statistically significant.Follow-up all patients for 3 months postoperation,no new stroke occurred at operation side.Conclusion:1.In the treatment of severe carotid artery stenosis by endarterectomy,the changes of eeg changes were consistent with electrophysiological monitoring,and had good sensitivity.2.The complication rate of Carotid endarterectomy under electroencephalogram monitoring was low and the effective in the treatment of severe carotid stenosis was satisfactory.3.CEA has better safety in the treatment of patients with severe carotid stenosis under continuous electroencephalogram monitoring.