Local anesthesia in carotid angioplasty.
OBJECTIVE
To determine the safety and efficacy of local anesthesia for percutaneous carotid angioplasty and stenting performed via a direct common carotid access.


METHODS
Deep cervical plexus blockade was used for anesthesia in 22 of 32 patients (26 males; mean age 66 years) undergoing percutaneous carotid balloon angioplasty and/or stenting via direct carotid puncture. Local anesthesia was selected according to patient preference (n = 9); advanced age (n = 4); ischemic heart disease (n = 4); intended extracorporeal circulation for unstable angina (n = 3); and an incompetent circle of Willis (n = 2). The technique involved injection of bupivacaine hydrochloride along the C2, C3, and C4 transverse processes. No superficial cervical plexus blockade was used.


RESULTS
No complications of anesthesia were observed, though there were cases in which surgery became necessary under local anesthesia for angioplasty-related complications. These conversions were accomplished without difficulty.


CONCLUSIONS
Cervical nerve blockade appears to be a safe and effective anesthetic method for endovascular carotid interventions performed percutaneously through direct carotid puncture.
Alessandri
C
C
Fondation Hôpital St. Joseph, Marseille, France.
Bergeron
P
P
D000367:Age Factors; D000368:Aged; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage; D000789:Angina, Unstable / Q000150:complications / Q000628:therapy; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage; D002340:Carotid Artery Diseases / Q000150:complications / Q000601:surgery / Q000628:therapy*; D017536:Carotid Artery, Common; D002561:Cerebrovascular Disorders / Q000150:complications; D002572:Cervical Plexus; D002941:Circle of Willis; D016894:Endarterectomy, Carotid; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications; D009407:Nerve Block / Q000379:methods; D011677:Punctures; D012449:Safety; D015607:Stents
D000779:Anesthetics, Local; D002045:Bupivacaine