CEA Neurological Deterioration — FRCA Final MCQ

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ModerateCardiothoracic AnaesthesiaCEA Neurological DeteriorationFRCA Final

Awake CEA under regional: patient becomes confused with contralateral arm weakness during carotid clamping. Immediate management?

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Reveal the answer and explanation

Correct answer: A — Ask surgeon to insert carotid shunt

Neurological deterioration during carotid cross-clamp = inadequate cerebral collateral flow. Immediate: surgeon inserts carotid shunt to restore perfusion. Primary advantage of awake CEA = real-time neurological monitoring.

Reference: Vascular Society/RCOA – 2023 – CEA guidelines