关键词: 颈动脉内膜切除术; 经颅检查; 多普勒; 经颅; 血流速度; 微栓子信号

Abstract: Objective The purposes of our study are to detective middle verebral artery (MCA) blood flowvelocity changes and microembolism during carotid endarterectomy(CEA) by transcranialDoppler(TCD) monitoring and to examine the suitability of intraoperative TCD monitoring.Methods Eighteen patients with internal carotid artery stenosis (>70%) or occlusive underwentCEA under TCD monitoring of peak systolic blood f low velocity, pulsatility index andmicroembolic signals in the ipsilateral middle cerebral artery.Results (1) Only one patient has got left ophthalmic artery embolism after CEA. (2) MCAvelocity and plusatility index increase significantly during period of cross release and woundclosure(P <0.01). 44.4% of patients with MCA velocity decrease over 60% at cross-clamping.77.8% of patients receive shunting. 33.3% of patients with MCA velocity increase over 100%at cross release. (3) Microembolic signal (MES) in 100% of patients was detected during CEA.The amount of MES are between 11 to 150, which the mean MES are 60±42. More MES weredetected at shunting and cross release.Conclusion Intraoperative TCD monitoring provides online surveillance of both hemodynamicchanges and cerebral microembolism in the middle cerebral artery on aspects of surgery, whichcan predict perioperative stroke effectively and optimize operation.

Key words: Endarterectomy; carotid; Ultrasonography; Doppler; transcranial; Blood fiowvelocity; Microembolic signal