Abstract

Aim: Carotid endarterectomy (CEA) is a widely used surgical procedure for treating carotid artery stenosis, yet perioperative stroke remains a significant complication. The optimal cerebral monitoring technique for guiding selective shunting during CEA is still under debate. This study examines the effectiveness of cerebral oximetry, utilizing the INVOS 5100 system, in monitoring cerebral perfusion and guiding the placement of selective shunts.
Material and Methods: This cross-sectional analytical study retrospectively analyzed data from 184 patients who underwent CEA with cerebral oximetry monitoring between 2014 and 2024. Variables collected included age, degree, and laterality of carotid occlusion, presence and type of preoperative symptoms, use of shunting, repair method, postoperative complications, and final surgical outcomes.
Results: The mean age of patients was 65.68±8.44 years. Postoperative recovery was observed in 179 patients (97.3%), while 5 patients (2.7%) died. No postoperative complications were reported. Statistical analysis showed no significant association between surgical outcomes and variables such as age, symptomatic status, side or severity of stenosis, shunt use, or repair method. A significant association was found between lower preoperative hemoglobin levels and adverse outcomes (p=0.021).
Conclusion: Our findings support the safety and effectiveness of CEA under cerebral oximetry monitoring using the INVOS 5100. The absence of complications and high rate of recovery suggest that cerebral oximetry may serve as a valuable tool for guiding selective shunting and improving surgical outcomes in carotid endarterectomy.

Key words: Endarterectomy, Elective shunting, Cerebral oximetry, Outcome, Stroke