Turkish Neurosurgery 2009 , Vol 19 , Num 1
Carotid Endarterectomy with Regional Anesthesia: An Audit of 71 Cases
Aykut KARASU1, Demet YANDIM KUŞÇU2, Göksel BAKAÇ3, Ender OFLUOĞLU4, Nesrin AKKOYUN5, Betül YALÇINER6, Cengiz DAYAN7, Sara BAHAR8, Talat KIRIŞ9, Muammer ÜYE10, Halil TOPLAMOĞLU11
1,9Istanbul University, Istanbul Medical Faculty, Neurosurgery Department, Istanbul, Turkey
2,3,6,7Bakırköy Research Hospital for Psychiatric and Neurological Diseases, Neurology Department, Istanbul, Turkey
10,4,5,11Bakırköy Research Hospital for Psychiatric and Neurological Diseases, Neurosurgery Department, Istanbul, Turkey
8Istanbul Medical Faculty, İstanbul University, Neurology Department, Istanbul, Turkey
AIM: 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.

MATERIAL and 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.

CONCLUSION: 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. Keywords : Carotid endarterectomy, Regional anesthesia, Carotid stenosis

Corresponding author : Demet Yandım Kuşçu, dykuscu@yahoo.com