Reappraisal of ocular pneumoplethysmography after carotid endarterectomy

An initial report documented a 3-year experience (1978 through 1980) with ocular pneumoplethysmography (OPG-Gee) done in the recovery room after carotid endarterectomy. The present report analyzes a similar 4-year experience (1981 through 1984) on 864 carotid endarterectomies performed by 20 surgeons in which the results of OPG tests done in the recovery room suggested carotid endarterectomy thromboses in 33 of the 864 patients (3.8%). All patients underwent immediate reoperation, and thromboses were confirmed in 26 of the 33 patients (79%). In the seven patients without thromboses, findings at reoperation accounted for the abnormal physiology in six of the seven patients. Overall, in 32 of the 33 patients (97%) the recovery room OPG tests accurately reflected a source of hemodynamic compromise. The application of the special OPG-Gee criteria in this report will minimize needless reoperation after carotid endarterectomy.