Regional cervical plexus blockage for carotid endarterectomy in patients with cardiovascular risk factors.
BACKGROUND
Carotid artery disease is not rare in cardiac patients. Patients with cardiac risk factors and carotid stenosis are prone to neurological and cardiovascular complications. With cardiac risk factors, carotid endarterectomy operation becomes challenging. Regional anesthesia is an alternative option, so we aimed to investigate the operative results of carotid endarterectomy operations under regional anesthesia in patients with cardiac risk factors.


METHODS
We aimed to analyze and compare outcomes of carotid endarterectomy under regional anesthesia with cardiovascular risk groups retrospectively. Between 2006 and 2014, we applied 129 carotid endarterectomy ± patch plasty to 126 patients under combined cervical plexus block anesthesia. Patients were divided into three groups (high, moderate, low) according to their cardiovascular risks. Neurological and cardiovascular events after carotid endarterectomy were compared.


RESULTS
Cerebrovascular accident was seen in 7 patients (5.55%) but there was no significant difference between groups (P &gt; .05). Mortality rate was 4.76% (n = 6); it was higher in the high risk group and was not statistically significant (P = .180). Four patients required revision for bleeding (3.17%). We did not observe any postoperative surgical infection.


CONCLUSIONS
Carotid endarterectomy can be safely performed with regional cervical anesthesia in all cardiovascular risk groups. Comprehensive studies comparing general anesthesia and regional anesthesia are needed.
Cardiovascular Surgery Department, Ankara University School of Medicine, Ankara, Turkey.
Mehmet
M
Taşar
Cardiovascular Surgery Department, Konya Education and Research Hospital, Konya, Turkey.
Mehmet
M
Kalender
Cardiovascular Surgery Department, Düzce University School of Medicine, Düzce, Turkey.
Okay Güven
OG
Karaca
Cardiovascular Surgery Department, Konya Education and Research Hospital, Konya, Turkey.
Ata Niyazi
AN
Ecevit
Cardiovascular Surgery Department, Nigde State Hospital, Nigde, Turkey.
Salih
S
Salihi
Cardiovascular Surgery Department, Kosuyolu Education and Research Hospital, Istanbul, Turkey.
Taylan
T
Adademir
Cardiovascular Surgery Department, Afyon Kocatepe University School of Medicine, Afyon, Turkey.
Osman Tansel
OT
Darçın
D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D016893:Carotid Stenosis / Q000401:mortality* / Q000628:therapy*; D066008:Cervical Plexus Block / Q000401:mortality* / Q000706:statistics & numerical data; D003131:Combined Modality Therapy / Q000401:mortality / Q000706:statistics & numerical data; D015897:Comorbidity; D016894:Endarterectomy, Carotid / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology