The value of monitoring transcranial Doppler ultrasonography combined with electroencephalogram detection in carotid endarterectomy

Objective: To evaluate the value of monitoring transcranial Doppler ultrasonography (TCD) combined with electroencephalogram (EEG) detection in carotid endarterectomy. Methods: A total of 73 patients with carotid artery stenosis were monitored by TCD and EEG, and digital subtraction angiography (DSA) was performed as the gold standard for detection. Results: DSA examination revealed that there were 7 patients with mild stenosis, 46 patients with moderate stenosis, 12 patients with severe stenosis, and 8 patients with normal internal carotid arteries. TCD detection showed that in 70 patients, when the common carotid artery on the affected side was clamped intraoperatively, the blood flow velocity of the middle cerebral artery decreased by about 1/2, and that in the other 3 patients, the blood flow velocity of the middle cerebral artery decreased by 100%. EEG test found that 59 patients showed no obvious abnormalities in EEG (all P>0.05), and the other 14 patients showed potential neuronal differences as changes in the brain wave frequency, which was manifested as a decreased a wave frequency. The peak systolic velocity (PSV), mean velocity (MV), end diastolic velocity (EDV), and pulsatility index (PI) of the middle cerebral artery increased after surgery (all P<0.05). The internal diameter of patients' postoperative carotid artery stenosis was 4.62 +/- 0.35 mm, which was significantly higher than the preoperative level (P<0.05). The positive rate and specificity of TCD combined with EEG detection in monitoring blood supply abnormalities were 93.17% and 82.35%, respectively; which were obviously higher than that of DSA, TCD and EEG tests alone (all P<0.05). Conclusion: The positive rate and diagnostic accuracy of TCD combined with EEG detection in monitoring cerebral blood supply abnormalities are higher than that of single detection, which is of great value in the prevention of complications in patients.