Related Experiment Video

Updated: Aug 2, 2025

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
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Cervical Debranching: Regional versus General Anesthesia for Carotid-Subclavian Bypass. A Single Center Experience

Aldin Mehmedovic1, Nikolaos Tsilimparis1, Konstantinos Stavroulakis1

  • 1Vascular Surgery Department, Ludwig Maximilian University Hospital, Munich, Germany.

Annals of Vascular Surgery
|April 21, 2023
PubMed

Insights

Regional anesthesia (RA) is a feasible and effective option for left subclavian artery (LSA) revascularization compared to general anesthesia (GA), with comparable complication rates. This study highlights RA as a viable anesthetic choice for LSA procedures.

Area of Science:

  • Vascular Surgery
  • Anesthesiology
  • Clinical Outcomes Research

Background:

  • Left subclavian artery (LSA) revascularization is a critical procedure for managing upper extremity ischemia.
  • Anesthesia choice for LSA revascularization, specifically comparing regional anesthesia (RA) and general anesthesia (GA), has not been extensively studied.
  • This study addresses this gap by comparing RA and GA in patients undergoing cervical debranching with carotid-subclavian bypass.

Purpose of the Study:

  • To compare the technical success and neurological complication rates of RA versus GA for LSA revascularization.
  • To evaluate secondary outcomes including postoperative bleeding, wound complications, and reintervention rates.
  • To determine the feasibility and effectiveness of RA as an anesthetic option for this patient population.

Main Methods:

  • A retrospective cohort study included 83 patients undergoing carotid-subclavian bypass from February 2018 to May 2022.
  • Patients were divided into two groups: those who received RA (n=37) and those who received GA (n=46).
  • Primary endpoints were technical success of RA and neurological complications (stroke, peripheral nerve lesions); secondary endpoints included bleeding, wound issues, and reintervention rates.

Main Results:

  • Technical success for RA was 89.2%.
  • Two minor strokes occurred in the GA group; peripheral neurological disorders occurred in 4 patients (2.7% RA, 6.5% GA).
  • Overall 30-day complication rates were 21.6% for RA and 32.6% for GA, with no statistically significant difference (P=0.266).

Conclusions:

  • Regional anesthesia (RA) is a feasible and effective anesthetic technique for carotid-subclavian bypass surgery.
  • RA demonstrated comparable safety and efficacy to general anesthesia (GA) in this cohort.
  • The findings support the consideration of RA for LSA revascularization procedures.
Abstract

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