Carotid arterial surgery using local anesthesia: a private practice retrospective study.
Carotid endarterectomy has recently become one of the more controversial operations. The tremendous increase in the number of endarterectomies performed, coupled with the apparent increase in morbidity and mortality associated with this operation in some studies, have brought into question the indications and results of the procedure. The potential for complications from the procedure itself, as well as increased morbidity and mortality from surgery on the elderly, make carotid endarterectomy a dangerous operation that must be done carefully and thoughtfully. The authors have performed carotid endarterectomies exclusively under local anesthesia to more closely evaluate the neurologic status of the patient. They believe that the operation performed in this manner obviates the use of a shunt and its inherent complications in greater than 80 per cent of the patients. This, coupled with the fact that many of the patients also have severe cardiac disease and the use of local anesthesia causes less hemodynamic changes and stress, should make carotid endarterectomy under local anesthesia the preferred approach.
Donato
A T
AT
Department of Surgery, Community Hospital of Roanoke Valley, Virginia.
Hill
S L
SL
D000367:Age Factors; D000772:Anesthesia, Local / Q000379:methods / Q000706:statistics & numerical data; D001766:Blindness / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D016893:Carotid Stenosis / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011331:Private Practice / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014768:Virginia / Q000453:epidemiology