Cerebral Blood Flow during Carotid Endarterectomy
Cerebral blood flow (CBF) was measured during 28 carotid endarterectomies in 25 patients, by injection of 133Xe into the exposed internal carotid artery (ICA). Twenty-three patients had episodic cerebral or retinal ischemia and five had neurologic deficits before operation. Initial CBF values were variable. Increases of PaCoCo2 caused CBF to increase in four of six patients, to increase slightly in one, and to decrease in one. In each of 19 procedures, CBF decreased during surgical occlusion of the ICA, 11 times to less than 30 ml/100 g/min, but absence of postoperative worsening indicated that decreased ICA blood flow is not a major risk of the procedure; embolization from the site of operation may be a greater threat to the patient. CBF increased after 14 endarterectomies, perhaps due to failure of autoregulation or to reactive hyperemia. Measurements of jugular PVoo2 and lactate concentration were of little value.
- Received October 29, 1971.
- Accepted December 3, 1971.
- © 1972 American Heart Association, Inc.