Report on initial experience with local anaesthesia for carotid artery endarterectomy.
OBJECTIVE
This prospective study reports our preliminary results with local anaesthesia (LA) for carotid endarterectomy (CEA).


METHODS
Twenty CEA in nineteen patients were performed using a three-stage local infiltration technique. CEA were performed through a short Duplex-assisted skin incision (median length: 55 mm) using a retro-jugular approach and polyurethane patch closure (median length: 35 mm).


RESULTS
There were 13 men and 6 women with a mean age of 71.2 years. The indications of CEA were asymptomatic lesions in 11 cases, stroke in 7 cases and transient ischaemic attack in 2 cases. The median degree of internal carotid artery stenosis was 90%. One patient (5%) required an intraluminal shunt. There were no peri-operative deaths, stroke or conversion to general anaesthesia (GA). The median length of stay was 3 days.


CONCLUSIONS
LA is a good alternative to GA. It can be used after a feasibility study and a short teaching procedure. In our centre, it is a safe and effective procedure associated with low morbidity, high acceptance by patients and a short hospital stay.
Department of Thoracic and Vascular Surgery, Clinique Saint-Pierre, Ottignies. vincent.scavee@skynet.be
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Scavée
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Detriche
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Van der Elst
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Chassot
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D016894:Endarterectomy, Carotid / Q000379:methods; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine