In carotid surgery, the measurement of somatosensory evoked potentials (SEPs) is recommended for monitoring the afferent pathways. This serves to identify inadequate blood supply of the cerebral hemispheres. Changes in SEP >> amplitudes and latencies indicate deficient blood perfusion. If the amplitudes decrease by 50% or the latencies increase by 10% compared to their baseline situation, it is regarded as a sign of beginning ischemia.
(Source: Domenick et. Al. 2018, „Somatosensory Evoked Potentials and Electroencephalography During Carotid Endarterectomy Predict Late Stroke But Not Death”, Ann Vasc Surg. 2017 January; 38: 105-112.)
Interventions in the carotid artery involve a risk of ischemic events. With the C2 NerveMonitor critical changes in the cerebral function can be recognized in time. Beside numerous other applications, the C2 NerveMonitor thus offers efficient neuromonitoring in vascular surgery.
The C2 SEP software was developed for precise neuromonitoring in vascular surgery. It is used to continuously monitor the sensory function. The stimulation electrodes are placed at the median nerve. Stimulation is then applied contralaterally to the surgical site. Recording is performed at the surgical site above the sensory cortex. A comparative measurement at the level of cervical vertebra C7 may also be useful.
Throughout the entire vascular surgical operation, the latency and amplitude of the recorded SEP signals are displayed as a trend. If the measured values reach an adjustable threshold level, the surgeon’s attention is drawn to this fact optically and acoustically. This allows a response to be made, for example by placing a shunt. Irreversible damage from deficient blood perfusion can thereby be avoided.
The intuitively applicable comment function of the SEP software offers the possibility of providing relevant time points (clamping, declamping etc.) during vascular surgery with comments. This facilitates the generation of a surgery report. Monitoring the individual stimulation responses is possible at all times.