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Morbidity and mortality of carotid endarterectomy under local anesthesia: a retrospective study

M Zuccarello1, H S Yeh, J M Tew

  • 1Department of Neurosurgery, University of Cincinnati, Ohio.

Neurosurgery
|October 1, 1988
PubMed

Insights

Carotid endarterectomy under local anesthesia is a safe procedure for patients with symptomatic extracranial occlusive vascular disease. This approach minimizes stroke and transient ischemic attack risks, even in high-risk individuals.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Anesthesiology

Background:

  • Carotid endarterectomy is established for reducing stroke incidence in symptomatic extracranial occlusive disease.
  • Perioperative complications like stroke or death are key concerns in this procedure.

Purpose of the Study:

  • To evaluate the safety and efficacy of carotid endarterectomy performed under local anesthesia.
  • To assess the outcomes in patients with transient ischemic attack or minor stroke.

Main Methods:

  • Retrospective study of 106 carotid endarterectomies in 100 patients.
  • Procedure performed under local anesthesia.
  • Analysis of perioperative complications, including stroke and transient ischemic attack.

Main Results:

  • Low incidence of nonfatal stroke (2%) and transient ischemic attack (1%).
  • Zero perioperative mortality observed.
  • Feasibility of performing the majority of procedures without an indwelling shunt.

Conclusions:

  • Carotid endarterectomy under local anesthesia is a safe option, even for high-risk patients.
  • Meticulous surgical technique is crucial for minimizing perioperative complications.
  • The procedure can often be performed without an indwelling shunt, enhancing patient safety.

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