Vascular Surgery

Neuromonitoring in vascular surgery

Neuromonitoring in vascular surgery involves the continuous monitoring of neural structures to ensure their integrity during procedures related to blood vessels. The primary goal is to detect and prevent neurological complications that may arise due to vascular interventions.

The Situation

Pathological alterations in the thyroid gland or scarring from multiple surgeries can cause nerve position changes, presenting challenges for surgeons based on their experience. There’s an elevated risk of vocal cord nerve paresis, particularly the laryngeal recurrent nerve, with potential serious implications for patients’ quality of life.

But what about patients under general anaesthesia?

Continuous measurement of somatosensory evoked potentials (SEPs) by a neuromonitor has become an indispensable tool in modern thyroid surgery over the past 15 years, aiding in risk reduction.

Risk reduction through SEP Monitoring

Specialised carotid programme

Using the AVALANCHE® SI neuromonitor for carotid endarterectomy (CEA) doesn’t require neurophysiologist training. Our carotid programme detects critical changes in somatosensory evoked potentials, alerting you to hypoxia risks in time. Dr. Langer Medical’s equipment is renowned for ease of use and essential focus.

Selective shunt insertion

Improved surgery workflow

For assessing changes in brain oxygen supply, SEPs are continuously measured. Any deviations are compared to the baseline signal recorded after anaesthesia induction. If amplitude and latency changes occur during surgery due to reduced oxygen supply—seen in fewer than 16% of CEAs—an intraluminal shunt may be necessary. This selective shunting lowers post-operative stroke risk to below 17%, without adding extra risk from intraoperative neuromonitoring.

Electrodes for stimulation and potential recording

From our range of accessories

For median nerve stimulation, surface electrodes are applied to the wrist and linked to the stimulator.

When it comes to recording EMG or EP signals or stimulating nerves and muscles, Dr. Langer Medical GmbH provides a wide array of needle electrodes for your neuromonitoring needs.

You’ll find a range of lengths, shapes, geometric arrangements, and colours to match your specific application requirements, ensuring you have the flexibility to choose what suits you best.

Thyroid Surgery
ENT / OM Surgery
Vascular Surgery
Neurosurgery
Spine Surgery
Rectal Surgery

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