[Severe Carotid Artery Disease:Monitoring and Precautions for Prevention of Cerebral Ischemia].

Cerebrovascular complications in cardiovascular surgery have long been documented. It is very important to diagnose and evaluate the stenosis of carotid artery before cardiovascular surgery. When indicated, carotid endarterectomy( CEA) or carotid artery stenting( CAS) for severe carotid artery stenosis may be considered before cardiovascular surgery. However, it has not been necessary performed in the real-world. It seems to be appropriate to maintain a mean arterial pressure of 50-70 mmHg during cardiovascular surgery with extracorporeal circulation. In addition, perioperative cerebral metabolism and circulation monitoring using a near-infrared cerebral oxygen monitor such as rSO2 is very useful from the viewpoint of preventing exacerbation of cerebral ischemia.