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Active Cerebral Perfusion During Carotid Endarterectomy

Department of Cardiovascular Surgery, Saitama Medical School, Saitama, Japan

For reprint information contact: Kazuhito Imanaka, MD Tel: 81 49 276 1562 Fax: 81 49 276 2062 Email: imanaka{at}saitama-med.ac.jp, Department of Cardiovascular Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan.

A patient with critical stenoses in the bilateral internal carotid arteries (ICA) required multivessel coronary revascularization. The diameter of the left ICA was far greater than the right, which strongly suggested that the cerebral circulation was highly dependent on the left. During left ICA endarterectomy, active cerebral perfusion of 300 mL·min^–1 at 23°C using an extracorporeal circulation was employed through the ICA under repair. Subsequently, coronary bypass was performed on-pump with the heart beating. The postoperative course was very good.