Luís Afonso Gamas , Hospital da Luz Clínica de Amarante and Clínica de Cerveira vascular surgeon, concluded his doctorate degree in Medicine at Oporto University Medical School (FMUP), receiving the unanimous approval of the jury. His thesis, entitled “Neuromonitoring and Outcome Predictors in Carotid Endarterectomy under Regional Anaesthesia”, was focused on the study of brain monitoring during carotid endarterectomy surgery, used in the prevention of cerebrovascular accidents (CVA) in selected groups of patients. CVA is a major cause of death in Portugal, 10 to 20% of cases being caused by atherosclerosis at the level of carotid arteries. During carotid endarterectomy surgery, it is necessary to temporarily clamp the carotid arteries (“cut” circulation in the intervened artery), the brain irrigation being maintained by collateral circulation. It is therefore fundamental to monitor the brain function, since about 10% of patients do not tolerate carotid clamping. In his research work, Luís Gamas examined the diagnostic precision of brain monitoring methods, in particular near-infrared spectroscopy (NIRS), during surgery, and the intraoperative hemodynamic profile of patients who do not tolerate clamping. Main conclusions of the research: NIRS showed insufficient sensitivity to detect cerebral ischemia during carotid endarterectomy, either conducted under general or regional anaesthesia. The use of NIRS is recommended in combination with more sensitive neuromonitoring methods. Patients nontolerant to carotid clamping presented on average higher systolic blood pressure from the moment of clamping, which could be an attempt of compensation in the presence of an ineffective collateral net. The results obtained allow a more accurate understanding of the neuromonitoring methods used in carotid endarterectomy, supporting more informed intraoperative decisions and contributing to the continuous improvement of safety and efficacy of the procedure. The thesis had João Rocha Neves for advisor and José Paulo Andrade and Ricardo Horta as co-advisors, all from Oporto University Medical School (FMUP). In the photo above, the new doctor and the jury: João Bernardes (FMUP, president of the jury), Augusto Ministro (Faculty of Medicine, Lisbon University), Petar Zlatanovic (Serbian University Clinical Centre, Belgrade), José Paulo Andrade (co-advisor), Luís Gamas, João Rocha Neves (advisor), Ricardo Horta (co-advisor), Mario d’Oria (Clinical Surgical and Health Sciences Department, Trieste University, Italy), Marina Neto (FMUP), and Susana Sá (FMUP).
