Cerebral Ischemia Clinical Trial
Official title:
Effect of Cafedrine/Theodrenaline and Urapidil During Carotid Endarterectomy on Cerebral Oxygenation Measured by Near Infrared Spectroscopy
During clamping of one internal carotid artery for endarterectomy, blood flow through this
vessel has to be compensated by collateral arteries including the contralateral internal
artery and vertebral arteries. In 7 % of all patients undergoing carotid endarterectomy this
collateral flow is not sufficient to maintain adequate cerebral perfusion during clamping
and ischemic brain damage is likely to emerge. To maximize cerebral blood flow during
clamping, increase of blood pressure is a common procedure and routine at our institution.
Increasing blood pressure can be enabled by tapering a mixture of Cafedrine und Theodrenalin
(Akrinor®) until the designated blood pressure is reached. After declamping, the blood
pressure has to be reduced to normal values to avoid postoperative hyperperfusion syndrome.
This is enabled by tapering urapidil until normal blood pressure is achieved.
It has been shown that cerebral oxygenation measured by near infrared spectroscopy is
reduced by intravenous application of norepinephrine. Otherwise, intravenous nitroglycerine
increases cerebral oxygenation during cardiopulmonary bypass. Hence, cafedrine/theodrenalin
and urapidil may also have an effect on cerebral perfusion. In this prospective randomized
study the effect of cafedrine/theodrenalin and urapidil on cerebral oxygenation measured by
near infrared spectroscopy is investigated.
n/a
Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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