Correlation of carotid artery stump pressure and neurologic changes during 474 carotid endarterectomies performed in awake patients

Using 40 mm Hg systolic as a threshold, the need for shunting (15%) and the false-negative rate (1.0%) for SP in our series were equivalent to the results of EEG monitoring during CEA reported in the literature. However, charges for SP measurements are dramatically lower compared with EEG monitoring. Our results suggest that a carotid artery SP ≥40 mm Hg systolic may be considered as an equally reliable but more cost-effective method to predict the need for carotid shunting during CEA under GA compared with EEG monitoring, but further investigation is warranted.