What may be the first sign of an impending stroke? - ✔️✔ Correct
Answer A TIA
Prodigy: What methods of monitoring cerebral perfusion are
commonly used during carotid cross-clamping with CEA procedures? -
✔️✔ Correct Answer EEG, somatosensory evoked potentials,
internal carotid artery stump pressure, cerebral oximetry, and
transcranial doppler. During awake carotid endarterectomy, the
patient's neurologic status and responsiveness is the indicator of
cerebral perfusion.
- Nagelhout
Prodigy: How should blood pressure be maintained during carotid
cross-clamp? - ✔️✔ Correct Answer The pressure should be at
or slightly above preoperative levels.
,Prodigy: How should you treat postoperative hypotension in a patient
who underwent a carotid endarterectomy? - ✔️✔ Correct
Answer Although not as common an event as postoperative
hypertension, hypotension can occur from carotid sinus
hypersensitivity, and can be difficult to treat because of the stress
many pharmacologic measures place on the heart. Prudent treatment
with intravenous fluids and vasopressors is the best course of action.
*Phenylephrine is typically the vasopressor administered.*
- Nagelhout
Stoetling: Surgical treatment of symptomatic carotid artery stenosis
greatly decreases the risk of stroke, especially in _______ with severe
carotid stenosis.
a. women
b. men - ✔️✔ Correct Answer b. men
, Stoetling: At what measurement is stenosis of the carotid arteries
considered hemodynamically significant? - ✔️✔ Correct
Answer Vessel diameter of 1.5 mm
Stoetling: Asymptomatic but high risk patients should only undergo
surgery at centers with complication rates of ______% or less per
year, or otherwise be medically managed.
a. 3%
b. 9%
c. 15%
d. 20% - ✔️✔ Correct Answer a. 3%
Stoetling: The incidence of perioperative MI in patients undergoing
CEA is: - ✔️✔ Correct Answer 0-4%