What are two potential vascular complications related to CEA?

The correct answer identifies "hyper-perfusion and hypo-perfusion" as two potential vascular complications related to carotid endarterectomy (CEA).

Hyper-perfusion occurs when there is an excessive flow of blood to the brain after the artery has been cleaned of plaque, leading to increased intracranial pressure and the potential for hemorrhage. In the context of CEA, this is especially concerning because the brain may have been deprived of blood supply before surgery, and once the artery is reopened, the sudden influx can cause vascular damage, especially to the small, fragile vessels.

Hypo-perfusion, conversely, refers to inadequate blood flow, which can lead to ischemia—a lack of oxygen supply to the brain tissue. This can occur if there are complications related to the surgery, such as arterial damage or a sudden drop in blood pressure, that limit the amount of blood being delivered to the brain.

These two conditions highlight the delicate balance of blood flow that must be maintained during and after carotid procedures. Monitoring for these complications is crucial during intraoperative monitoring as they can significantly affect patient outcomes.