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Safe carotid endarterectomy: "one fits all strategy"
Ahmet Unlu1, Ahmet Baris Durukan1
1Department of Cardiovascular Surgery, Medical Park Usak Hospital, Usak, Turkey.
Summary
Carotid endarterectomy is a safe procedure for treating carotid artery stenosis. Continuous cerebral oxygenation monitoring is essential during surgery, and our "one fits all strategy" proved effective.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Carotid artery stenosis (CAS) accounts for 10-15% of all strokes.
- Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are intervention options, with CEA showing superiority.
Purpose of the Study:
- To evaluate the safety and efficacy of a standardized "one fits all strategy" for carotid endarterectomy.
Main Methods:
- Retrospective study of 76 patients undergoing CEA between July 2016 and April 2020.
- Conventional endarterectomy under general anesthesia with primary closure.
- Continuous regional cerebral oxygenation monitoring using near-infrared spectroscopy (NIRS).
Main Results:
- Mean patient age was 70.96 years; 52 were male.
- Mean follow-up was 20.6 months; 73.6% had coronary artery disease.
- Two perioperative strokes occurred (one full, one partial recovery); 8 hematomas required revision.
Conclusions:
- CEA remains a safe and effective treatment for carotid artery stenosis.
- Continuous NIRS monitoring is crucial for patient safety during CEA.
- "One fits all strategy" (general anesthesia, conventional CEA, no shunt, NIRS monitoring) is safe and effective.
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