In vascular surgery and especially in operations on the carotid artery, the measurement of somatosensory evoked potentials (SEP) is recommended. The electrophysiological early warning to protect against reduced blood flow in vascular surgery and in particular in operations on the carotid artery can be carried out via the continuous discharge of the SEPs. This method is a good alternative to Doppler sonography for carotid surgery, for example, and can indicate incipient cerebral ischemia due to the temporary clamping of the carotid artery during carotid surgery.
Changes in the SEPs during surgical therapy, for example of carotid stenosis (narrowing of the cervical artery), help the surgeon to recognise a possible reduced blood flow and to initiate countermeasures in good time. The surgeon has the opportunity to change his surgical strategy during the carotid surgery in order to prevent postoperative neurological deficits.
A thoracic and thoracoabdominal aortic aneurysms are pathological dilatations of the aorta. Typical symptoms are chest or back pain. In an advanced aneurysm, rupture or dissection may occur, resulting in a high mortality rate.
The specially developed SEP software for the C2 Xplore >> enables reliable stimulation of the somatosensory nerves and corresponding signal derivation at the sensory cortex with clear display of the SEP signals during the operation. This additional protection is specially designed for continuous monitoring against ischemic events.
In thoracoabdominal aortic surgery, spinal ischemia also represents a risk which can be detected by continuous SEP derivation and additional motor evoked potentials (MEPs). The ISIS IOM System >> with its high number of channels and countless combination possibilities offers multimodal monitoring of the spinal cord pathways. Changes in the SEPs and MEPs indicate disturbances in the spinal cord pathways, which provides the surgeon and the patient with increased risk coverage during the life-saving procedure.
Overall, neurophysiological monitoring, in particular the derivation of SEPs, can optimize the quality of surgical therapy during carotid and thoracoabdominal aortic surgeries and thus improve the postoperative quality of life of patients.