Carotid endarterectomy with regional anesthesia: an audit of 71 cases.
OBJECTIVE
The aim of carotid endarterectomy (CEA) is the successful removal of the atherosclerotic plaque and meticulous anatomical and physiological reconstruction of the carotid artery without any perioperative complications. Endarterectomy can also be carried out with regional anesthesia, which allows monitoring of the neurological status. This study reviews patients who underwent CEA with regional anesthesia.


METHODS
A total of 71 consecutive patients were planned to undergo carotid endarterectomy under regional anesthesia between 2000 and 2006. All of these patients, assessed by our neurovascular team, were recruited prospectively and the data was analyzed retrospectively.


RESULTS
The study group consisted of 23 women and 48 men with a mean age of 62 (range 37-79). 67 patients (94,4%) had symptomatic, and 4 (5,6%) had asymptomatic (5.6%) carotid stenosis. Six patients (8.45%) were intolerant to carotid clamping (8,45%). The stroke morbidity rate was 1.4% and the mortality rate was 1.4%. The mean hospitalization time was 2.07 (range 1-10) days.


CONCLUSIONS
Carotid endarterectomy performed under regional anesthesia can be a safe method which may lead to better neurological outcome. This method offers several advantages including monitorization of the cerebral ischemia during surgery, usage of selective shunting, decreased need for intensive care and shorter hospitalization time.
Karasu
Aykut
A
Istanbul University, Istanbul Medical Faculty, Neurosurgery Department, Istanbul, Turkey.
Kuşçu
Demet Yandim
DY
Bakaç
Göksel
G
Ofluoğlu
Ender
E
Akkoyun
Nesrin
N
Yalçiner
Betül
B
Dayan
Cengiz
C
Bahar
Sara
S
Kiriş
Talat
T
Uye
Muammer
M
Toplamoğlu
Halil
H
D000328:Adult; D000368:Aged; D000765:Anesthesia, Conduction / Q000401:mortality*; D016893:Carotid Stenosis / Q000401:mortality* / Q000601:surgery*; D015897:Comorbidity; D003422:Critical Care / Q000706:statistics & numerical data; D016894:Endarterectomy, Carotid / Q000401:mortality*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies