Microsurgical endarterectomy under barbiturate protection: a prospective study

Area of Science:

• Vascular Surgery
• Neurology
• Neurosurgery

Background:

• Carotid artery disease poses a risk of stroke.
• Symptomatic patients with specific lesions may benefit from intervention.
• Low perioperative complication rates are crucial for successful carotid endarterectomy.

Purpose of the Study:

• To outline a microsurgical carotid endarterectomy protocol.
• To evaluate the safety and efficacy of this protocol.
• To determine the perioperative morbidity and mortality rates.

Main Methods:

• Preoperative antiplatelet therapy.
• Barbiturate anesthesia for cerebral protection.
• Microsurgical technique without an internal shunt.
• Strict postoperative hypertension control.

Main Results:

• A series of 200 consecutive carotid endarterectomies were performed.
• The protocol involved 180 patients.
• The combined permanent morbidity and mortality rate was 1.5%.

Conclusions:

• The described microsurgical carotid endarterectomy protocol is safe and effective.
• This approach can significantly reduce stroke risk in symptomatic patients.
• Low complication rates are achievable with meticulous surgical technique and management.