Relationship between regional cerebrovascular oxygen saturation and jugular bulb oxygen saturation during carotid endarterectomy

Background: Carotid artery cross-clamping ischemia during carotid endarterectomy (CEA) sometimes causes perioperative neurological deficits. Therefore it is important to asses the cerebral oxygen supply/demand relationship during CEA. The aim of this study is to examine the relationship between two monitoring results in CEA.

Methods: Six patients undergoing elective carotid CEA were studied. Regional cerebrovascular oxygen saturation (rSO2) and jugular bulb oxygen saturation (SjvO2) were measured simultaneously during carotid artery cross-clamping.

Results: In 5 patients, rSO2 and SjvO2 changed similarly during carotid artery cross-clamping. In one patient, whose arterial cross flow through the anterior communicating artery was poor, rSO2 markedly decreased after cross-clamping, but SjvO2 was unchanged during the same procedure.

Conclusions: Patients with internal carotid artery stenosis have individually different characteristics in cerebral metabolism and cerebral blood perfusion. Our results suggest that multiple monitoring of cerebral blood flow and oxygen saturation provides helpful information in CEA patients.