• World Neurosurg · Oct 2020

    Case Reports

    Transient retinal ischemia during carotid endarterectomy estimated by intraoperative visual evoked potential monitoring: Technical note.

    • Yota Suzuki, Tetsuya Goto, Yu Fujii, Yosuke Hara, Kunihiko Kodama, Atsushi Sato, Tetsuyoshi Horiuchi, and Kazuhiro Hongo.
    • Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
    • World Neurosurg. 2020 Oct 1; 142: 68-74.

    ObjectiveCarotid revascularization surgery is known to carry a risk of postoperative visual deterioration associated with retinal ischemia. We checked intraoperative visual evoked potential (VEP) monitoring in carotid endarterectomy (CEA).MethodsTen consecutive patients who underwent CEA in Shinshu University Hospital under total intravenous anesthesia were checked by intraoperative VEP and electroretinogram (ERG) recording in addition to somatosensory evoked potential monitoring.ResultsTwo of 10 patients presented decreased amplitude of VEP and ERG on the ipsilateral affected side by clamping the common carotid artery and persistent attenuation of VEP and ERG during external carotid artery occlusion, using an internal carotid shunt. These findings disappeared immediately after releasing the cervical carotid artery clamping. In the other 8 patients, VEP and ERG did not change throughout the surgery.ConclusionsTransient retinal ischemia during even brief carotid artery occlusion in the CEA procedure could be estimated by intraoperative VEP and ERG monitoring.Copyright © 2020 Elsevier Inc. All rights reserved.

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