SURGICAL STRATEGY FOR PATIENTS UNDERGOING CAROTID ENDARTERECTOMY.

Area of Science:

• Vascular Surgery
• Neurology
• Cardiology

Background:

• Carotid atherosclerosis poses a risk for stroke and neurological deficits.
• Carotid endarterectomy (CEA) aims to mitigate these risks.
• Understanding risk factors and complications is crucial for effective intervention.

Purpose of the Study:

• To investigate major risk factors associated with carotid endarterectomy.
• To analyze surgical techniques and diagnostic methods used in CEA.
• To evaluate perioperative complications in patients undergoing CEA.

Main Methods:

• A retrospective analysis of 496 carotid endarterectomy procedures performed between 1987-2009.
• Utilized standard surgical access under general or local anesthesia.
• Employed transcranial Doppler Ultrasound (TCD) and cerebral oximetry (CO) for perioperative monitoring.
• Selective use of carotid shunting based on hemodynamic and functional indicators.

Main Results:

• Stroke occurred in 2.7% of asymptomatic and 1.7% of symptomatic patients.
• Cardiac complications, including hemodynamic disorders and myocardial infarction, were most prevalent.
• Postoperative mortality rates were low.

Conclusions:

• Carotid endarterectomy demonstrates low postoperative mortality and stroke rates, comparable to leading centers.
• CEA is a safe and effective surgical option for stroke prevention in both symptomatic and asymptomatic individuals.
• Precise perioperative diagnostics are essential for selecting optimal surgical strategies.