The choice of method for cerebral protection from ischemia in carotid endarterectomy

The outcome of surgical treatment of occlusive diseases of aortic brachiocephalic branches depends not only on irreproachable surgical technique (1), but also upon an adequate intraoperative protection of brain from ischemia (3, 4, 6). In this connection, the major task within the algorithm of examining patients suffering from chronic vascular insufficiency consists of studying intracerebral hemodynamics, the condition and compensatory capacity of collateral circulation, and definition of cerebral tolerance to ischemia. The major goal of the present study includes evaluation of both transcranial Dopplerog-raphy (TCD) and electroencephalography (EEG) potentialities to estimate the cerebral tolerance to ischemia and to choose adequate measures to protect it from intraoperative ischemic injuries while reconstructing carotid arteries (2, 5).