We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Cerebral Protection in Carotid Surgery

Anthony M. Imparato, MD; Anthony Ramirez, MD; Thomas Riles, MD; Ronnie Mintzer, BSN
Arch Surg. 1982;117(8):1073-1078. doi:10.1001/archsurg.1982.01380320057015.
Text Size: A A A
Published online


• We performed 956 carotid endarterectomies in 661 conscious patients who were under cervical block anesthesia and in whom the stroke rate was 2.5%. They were analyzed to determine the mechanisms of strokes and the risk factors for perioperative stroke. Twenty-three patients with perioperative strokes, regardless of severity, were analyzed as to the mechanism of cause. One half were due to technical problems, one quarter to intraoperative embolization, one sixth to intracerebral hemorrhage, and the remainder were not directly related to the operative procedures. Perioperative stroke rate varied by group from 0.6% to 28.4%, highest when the contralateral carotid was occluded, where there was a preoperative persistent neurologic deficit, and when the patient failed to tolerate carotid clamping. Regional block monitoring was accurate and no stroke could be ascribed to anesthetic technique. Standard reporting techniques should be used in classifying patients into appropriate risk groups to permit meaningful comparisons among groups using different techniques for cerebral protection.

(Arch Surg 1982;117:1073-1078)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.