Podcast
Questions and Answers
What is the most common cause of postoperative stroke after carotid endarterectomy (CEA)?
What is the most common cause of postoperative stroke after carotid endarterectomy (CEA)?
- Tension pneumothorax
- Development of an incisional hematoma
- Neurologic deficits during initial assessment
- Thrombus formation and embolization of plaque debris (correct)
What is the immediate intervention after a significant incisional hematoma is discovered post CEA?
What is the immediate intervention after a significant incisional hematoma is discovered post CEA?
- Notification of the surgeon to evacuate the hematoma (correct)
- Relieving the pressure on the structures of the neck
- Airway management
- Immediate re-exploration of the surgical site
What might contralateral asymmetry in a patient's smile indicate after carotid endarterectomy?
What might contralateral asymmetry in a patient's smile indicate after carotid endarterectomy?
- Facial nerve damage (correct)
- Spinal accessory nerve damage
- Glossopharyngeal nerve damage
- Vagus nerve damage
Which cranial nerve controls the pharyngeal muscles and the ability to swallow?
Which cranial nerve controls the pharyngeal muscles and the ability to swallow?
Unilateral damage to which laryngeal nerve can cause hoarseness?
Unilateral damage to which laryngeal nerve can cause hoarseness?
Which cranial nerve controls the sternocleidomastoid and trapezius muscles?
Which cranial nerve controls the sternocleidomastoid and trapezius muscles?
Which nerve is responsible for control of the muscles of the tongue?
Which nerve is responsible for control of the muscles of the tongue?
What is the formula for cerebral perfusion pressure (CPP)?
What is the formula for cerebral perfusion pressure (CPP)?
What shifts the autoregulation curve to the right in patients with hypertension?
What shifts the autoregulation curve to the right in patients with hypertension?
What is the normal range for cerebral metabolic requirements for oxygen (CMRO2)?
What is the normal range for cerebral metabolic requirements for oxygen (CMRO2)?
What is the effect of hyperthermia on cerebral metabolic requirements for oxygen (CMRO2)?
What is the effect of hyperthermia on cerebral metabolic requirements for oxygen (CMRO2)?
What is the recommended carotid artery stenosis percentage for symptomatic patients to undergo carotid endarterectomy?
What is the recommended carotid artery stenosis percentage for symptomatic patients to undergo carotid endarterectomy?
What is the estimated prevalence of carotid artery stenosis in individuals over the age of 80?
What is the estimated prevalence of carotid artery stenosis in individuals over the age of 80?
Which vessels are responsible for supplying 80% to 90% of the blood to the brain?
Which vessels are responsible for supplying 80% to 90% of the blood to the brain?
What is normally autoregulated over a range of mean arterial pressures from 60 to 150 mm Hg?
What is normally autoregulated over a range of mean arterial pressures from 60 to 150 mm Hg?
What results in a predictable pattern of neurologic symptoms specific to the area of the brain supplied by the vessel?
What results in a predictable pattern of neurologic symptoms specific to the area of the brain supplied by the vessel?
What is the recommendation for symptomatic patients with carotid artery stenosis of less than 30%?
What is the recommendation for symptomatic patients with carotid artery stenosis of less than 30%?
What is a risk factor for postoperative hypertension after carotid endarterectomy (CEA)?
What is a risk factor for postoperative hypertension after carotid endarterectomy (CEA)?
What is the main concern regarding patients with severe hypertension undergoing surgical correction?
What is the main concern regarding patients with severe hypertension undergoing surgical correction?
What is the leading cause of mortality after carotid endarterectomy (CEA)?
What is the leading cause of mortality after carotid endarterectomy (CEA)?
What should be assessed in the preoperative evaluation of patients undergoing carotid endarterectomy (CEA) due to the high risk of neurologic events?
What should be assessed in the preoperative evaluation of patients undergoing carotid endarterectomy (CEA) due to the high risk of neurologic events?
What is the main advantage of utilizing regional anesthesia for carotid endarterectomy (CEA)?
What is the main advantage of utilizing regional anesthesia for carotid endarterectomy (CEA)?
What contributes to the increased risk of stroke or death after CEA?
What contributes to the increased risk of stroke or death after CEA?
What is the purpose of transcranial Doppler monitoring during carotid endarterectomy (CEA)?
What is the purpose of transcranial Doppler monitoring during carotid endarterectomy (CEA)?
What is a complication associated with carotid artery angioplasty and stent placement (CAS)?
What is a complication associated with carotid artery angioplasty and stent placement (CAS)?
What was traditionally used to determine the need for shunt placement during carotid cross-clamping before the introduction of more sophisticated cerebral monitoring techniques?
What was traditionally used to determine the need for shunt placement during carotid cross-clamping before the introduction of more sophisticated cerebral monitoring techniques?
Why is intraoperative EEG and SSEP monitoring used for patients undergoing carotid endarterectomy (CEA)?
Why is intraoperative EEG and SSEP monitoring used for patients undergoing carotid endarterectomy (CEA)?
What is the rationale for administering heparin intraoperatively before carotid artery cross-clamping?
What is the rationale for administering heparin intraoperatively before carotid artery cross-clamping?
Why is controlling the patient's blood pressure during carotid endarterectomy (CEA) important?
Why is controlling the patient's blood pressure during carotid endarterectomy (CEA) important?
What is the purpose of carotid shunting during carotid cross-clamping?
What is the purpose of carotid shunting during carotid cross-clamping?
What is the purpose of reverse anticoagulation with protamine after carotid endarterectomy?
What is the purpose of reverse anticoagulation with protamine after carotid endarterectomy?
What is the recommended minimum MAP (mean arterial pressure) to be maintained throughout the cross-clamp time during carotid endarterectomy (CEA)?
What is the recommended minimum MAP (mean arterial pressure) to be maintained throughout the cross-clamp time during carotid endarterectomy (CEA)?
Which medication can be utilized for titratable control of blood pressure if hypertension is sustained during carotid endarterectomy (CEA)?
Which medication can be utilized for titratable control of blood pressure if hypertension is sustained during carotid endarterectomy (CEA)?
What is the initial treatment for bradycardia that is caused by the baroreceptor reflex and results in severe hypotension during carotid endarterectomy (CEA)?
What is the initial treatment for bradycardia that is caused by the baroreceptor reflex and results in severe hypotension during carotid endarterectomy (CEA)?
What is one of the postoperative risk factors for the development of cerebral hyperperfusion syndrome after CEA?
What is one of the postoperative risk factors for the development of cerebral hyperperfusion syndrome after CEA?
What is an intervention for sustained systolic blood pressures > 180 mm Hg in the postoperative period after carotid endarterectomy (CEA)?
What is an intervention for sustained systolic blood pressures > 180 mm Hg in the postoperative period after carotid endarterectomy (CEA)?
What is the initial intervention after a hematoma is discovered post CEA?
What is the initial intervention after a hematoma is discovered post CEA?
What do significant incisional hematomas post CEA have the potential to cause?
What do significant incisional hematomas post CEA have the potential to cause?
What condition is associated with miosis, ptosis, and anhidrosis, resulting from damage to the glossopharyngeal nerve?
What condition is associated with miosis, ptosis, and anhidrosis, resulting from damage to the glossopharyngeal nerve?
Which nerve controls the intrinsic muscles of the larynx and can cause hoarseness if unilaterally damaged during CEA?
Which nerve controls the intrinsic muscles of the larynx and can cause hoarseness if unilaterally damaged during CEA?
What is the main function of the spinal accessory nerve that may be compromised during CEA?
What is the main function of the spinal accessory nerve that may be compromised during CEA?
What does damage to the hypoglossal nerve result in?
What does damage to the hypoglossal nerve result in?
What does unilateral damage to the internal branch of the superior laryngeal nerve result in?
What does unilateral damage to the internal branch of the superior laryngeal nerve result in?
What is indicative of a possible intraoperative cerebral vascular accident (CVA) when assessing postoperative patients having a CEA?
What is indicative of a possible intraoperative cerebral vascular accident (CVA) when assessing postoperative patients having a CEA?
What is associated with vocal cord paralysis, hoarseness, and respiratory difficulty on the operative side after unilateral damage?
What is associated with vocal cord paralysis, hoarseness, and respiratory difficulty on the operative side after unilateral damage?
What is an expected consequence of damage to the facial nerve?
What is an expected consequence of damage to the facial nerve?
