Importance of cerebral angiography and intraoperative neuromonitoring in carotid endarterectomy.

We present a case of symptomatic left carotid artery 80% stenosis in which cerebral angiography showed absence of the right A1 segment and bilateral anterior cerebral artery territories that filled only from a left injection. Just 90seconds after carotid artery clamping at the neck, brain oximetry and somatosensory evoked potentials significantly dropped, that recovered after immediate clamp removal. Endarterectomy was dismissed and a carotid stent was successfully placed. This case highlights the importance of knowing the dynamics of cerebral blood circulation distal to the stenosis. If endarterectomy had been attempted, unawareness of the information provided by the cerebral angiography would have likely result in severe bi-hemispheric ischemia. PMID: 32386931 [PubMed - as supplied by publisher]
Source: Neurocirugia - Category: Neurosurgery Authors: Tags: Neurocirugia (Astur) Source Type: research