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Carotid endarterectomy using regional anesthesia: technique and considerations
Varun Padmanaban1, Catherine Caldwell1, Indigo Milne1
1Department of Neurosurgery, Pennsylvania State University College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, United States.
Frontiers in Surgery
|June 21, 2024
Summary
Awake carotid endarterectomy (CEA) using regional anesthesia offers a safe and effective approach to reduce stroke risk. This technique may decrease complications and hospital stays in select patients.
Area of Science:
- Vascular Surgery
- Anesthesiology
- Neurology
Background:
- Carotid endarterectomy (CEA) is a key procedure for reducing stroke risk in patients with carotid stenosis.
- Awake CEA under regional anesthesia may offer benefits like fewer perioperative complications and shorter hospital stays.
- Detailed descriptions of awake CEA techniques are limited in published literature.
Purpose of the Study:
- To present the experience with CEA performed under regional anesthesia.
- To highlight patient selection criteria, anatomical variations, and surgical techniques, including cervical regional blocks.
- To emphasize the specific advantages and challenges of the awake surgical approach.
Main Methods:
- Detailed description of the CEA procedure utilizing regional anesthesia.
- Focus on the practical aspects and nuances of conducting CEA in awake patients.
Main Results:
- Demonstrated successful application of regional anesthesia for CEA.
- Reported no complications associated with the use of regional anesthesia during the procedure.
Conclusions:
- Regional anesthesia is a beneficial approach for carotid plaque removal in suitable patients undergoing CEA.
- Careful patient selection and a thorough understanding of relevant anatomy are crucial for successful outcomes.
- The study discusses the potential advantages and disadvantages of this anesthetic technique.
