What is the role of somatosensory evoked potentials (SEPs) in carotid endarterectomy monitoring?

Updated: Oct 25, 2019
  • Author: Andrew B Evans, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Duffy et al compared the results of cerebral oximetry and SEP monitoring in carotid endarterectomy. [78] A 50% decrease in SEP amplitude and a 10% decrease in regional oxygen saturation (rSO2) were considered clinically significant. Compared with SEP, rSO2 had a sensitivity of 50% and a specificity of 96%. [78] Clinical experience with this evolving technology is ongoing. Its role in neurovascular procedures has yet to be established.

Fiori and Parenti used 2-channel electroencephalography (EEG) and SEP monitoring for selective shunting during 255 carotid endarterectomies for severe carotid stenosis; they found that computerized EEG is an easily interpretable method of monitoring and reveals rapidly developing cerebral ischemia but that severe SEP changes can occur in spite of a normal EEG pattern when cerebral ischemia has a slow onset. SEP monitoring is a slower recording method of but can yield a finer distinction of less severe cerebral ischemia.


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