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The efficiency of carotid surgery on an asymptomatic carotid artery stenosis and its superiority to conservative treatment was clearly demonstrated in the ACAS study. The stroke risk over a five year follow-up period could be reduced by 55 % and the combined stroke and mortality rate was shown to be a mere 2. 3 %. The efficacy of surgical treatment in also reducing stroke rates in the case of a symptomatic carotid stenosis was proven in the NASCET and ECTS prospective randomized studies. Of extreme importance in these procedures is, however, precise quality control and quality assessment. This is presently a topic of tremendous interest in reconstructive vascular surgery and is constantly being discussed in specialist circles and beyond. Documentation and the possibility of accurate reconstruction of the intraoperative situation are in high demand. Perioperative monitoring of neurological function, particularly the monitoring during carotid surgery, are the aspects underlying constant revision and reassessment to ensure quality control and assurance of a negligeable mortality and morbidity rate. The aim of this book is to discuss the presently available perioperative control methods, examinations, and quality assessments, and the critical consideration of these. We would like to express our thanks to all authors who helped achieve the sense and aim of this book. A special word of thanks to Dr. Kerstin Simons (assistant surgeon) for assisting in the editing of the numerous presentations in this book. Particularly we thank Dr.
This book is a comprehensive, focused resource on intraoperative neurophysiological monitoring (IOM). This rapidly evolving field has created a demand for an up-to-date book such as this that builds on foundational concepts necessary to the practice of IOM in the context of anatomy and physiology. Each chapter is designed to not only inform the reader, but to also test the reader on the information presented - therefore promoting practical, problem-based learning. Surpassing the quality of its successful predecessor, Principles of Neurophysiological Assessment, Mapping, and Monitoring, Second Edition, is positioned to suit the needs of residents and fellows studying for the IOM certificate programs, physicians and anesthesiologists practicing IOM, and neurotechnologists both experienced and in training.
Background and Goal of Study: Endarterectomy (CEA) is the standard treatment of carotid stenosis. Continuous EEG is one of the monitoring used to detect cerebral ischemia (1). When this appears, the EEG changes and the hemodynamic variations induced either spontaneously or by the anesthesiologist are not described. We therefore reviewed the peroperative electronic records of our patients anaesthetised for CEA to describe these modifications.Materials and Methods: This is a retrospective single institution study, approved by our IRB, that reviewed the data recorded by our anesthesia information management system (Innovian Anesthesia Drager) in 275 patients who underwent CEA from 01 2012 till 12 2016. All the cases were performed under general anesthesia with propofol and remifentanil controlled by TCI using respectively the Schnider or the Minto model. A continuous EEG using 10 leads placed as described by the.
Intraoperative Neuromonitoring takes you step by step through the proper protocols for measuring and mapping neural function, emphasizing the correct application of intraoperative recordings for improved surgical outcomes. You will learn how to utilize the very latest neuromonitoring tools, and familiarize yourself with the full range of topics pertaining to intraoperative monitoring in neurosurgery. The authors also present both common and lesser-known techniques for neural assessment, resulting in a stand-alone reference that helps you master any type of neuromonitoring for virtually every kind of procedure. The most complete, expert-authored intraoperative neuromonitoring resource, addressing the most current topics, tools, and techniques to enhance your skills. Logical five-part organization clearly explains must-know topics such as neuromonitoring during cerebrovascular surgery, mapping cerebral and brainstem function, neuromonitoring in spinal surgery peripheral nerve procedures, and more.
The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.
Anesthesia for Otolaryngologic Surgery offers a comprehensive synopsis of the anesthetic management options for otolaryngologic and bronchoscopic procedures. Authored by world authorities in the fields of anesthesiology and otolaryngology, both theoretical concepts and practical issues are addressed in detail, providing literature-based evidence wherever available and offering expert clinical opinion where rigorous scientific evidence is lacking. A full chapter is dedicated to every common surgical ENT procedure, as well as less common procedures such as face transplantation. Clinical chapters are enriched with case descriptions, making the text applicable to everyday practice. Chapters are also enhanced by numerous illustrations and recommended anesthetic management plans, as well as hints and tips that draw on the authors' extensive experience. Comprehensively reviewing the whole field, Anesthesia for Otolaryngologic Surgery is an invaluable resource for every clinician involved in the care of ENT surgical patients, including anesthesiologists, otolaryngologists and pulmonologists.
From patient selection and monitoring to follow-up care, Carotid Interventions is the first source to offer a practical how-to approach to carotid angioplasty and stenting-providing maneuvers and strategies for difficult situations, as well as step-by-step guidance on specific surgical procedures, equipment selection and instrumentation, protection
Detailed discussion of evaluation, management, and post-operative care You'll find information on state-of-the-art techniques, imaging modalities, and current evaluation issues in carotid artery surgery. Plus, this book provides the endovascular data which has been missing in carotid textbooks until now. Highlights of this work: Detailed analysis of the latest techniques, including endovascular procedures and special methods of carotid reconstruction Collaboration between neurosurgeons, vascular surgeons, radiologists, and other surgical groups provides the most complete review of the field available The most up-to-date information on diagnosis, imaging, preoperative evaluation, and perioperative monitoring Insightful discussion of controversial issues in surgical management, post-operative care, and the future of carotid endarterectomy The modern guide to carotid artery surgery... Carotid Artery Surgery's interdisciplinary approach makes it the state-of-the-art reference for any specialist who deals with carotid endarterectomy. The book brings together the newest information in the field and points the way to future developments. Neurosurgeons, vascular surgeons, and neurologists, among others, will find this book to be an interesting, as well as valuable reference.
Close monitoring of patients during anesthesia is crucial for ensuring positive treatment outcomes and patient safety. The increasing availability of new technologies and the repurposing of older monitors means more patient data is at anesthesiologists' fingertips than ever before. However, this flood of options can be overwhelming. A practical resource for understanding this array of clinical monitoring options in anesthesia, this important text focuses on real-world applications in anesthesia and perioperative care. Reviewing the evidence for improved patient outcomes for monitoring technology, neurological monitoring, echocardiography systems and ultrasound are amongst the techniques covered in a head-to-toe approach. Statistics used by manufacturers to gain approval for their technology are discussed, as well as the under-appreciated risks associated with monitoring such as digital distraction. Future monitoring technologies including wearable systems are explored in depth. Focusing on applied practice, this book is an essential text for front-line healthcare professionals in anesthesia.