Evoked potentials for quality control during surgery of the carotid artery

In order to evaluate the relation between costs and benefit of the use of a temporary shunt during surgery of the carotid artery, we analysed 356 patients undergoing 401 operations of the carotid artery in a period from January 1991 to August 1995 in a retrospectiv study. The morbidity and mortality during hospital stay were 1,75% respectivly 0,75 % referring to neurological outcome and death. The potential to economize surgery of the carotid artery by recording the somatosensory evoked potentials in order to select the patients requiring a temporary shunt would be 4,1% of the payment which will be payed from 1996 by the social insurances for carotid endarterectomy. These savings can be realized without loss of quality or higher risk for the patient.