Related Experiment Videos
Local anesthesia in carotid endarterectomy: an alternative method
Israel Journal of Medical Sciences
|June 1, 1985
Summary
Carotid endarterectomy under local anesthesia is a safe procedure with no 30-day deaths in 41 operations. Neurological monitoring of awake patients accurately guides the need for shunts, making it ideal for elderly patients.
Area of Science:
- Vascular Surgery
- Neurology
- Anesthesiology
Background:
- Carotid endarterectomy is a surgical procedure to remove plaque from carotid arteries.
- Local anesthesia offers potential benefits, especially for high-risk patients.
Purpose of the Study:
- To evaluate the safety and efficacy of carotid endarterectomy performed under local anesthesia.
- To assess the utility of neurological monitoring in awake patients during the procedure.
Main Methods:
- Retrospective analysis of 41 carotid endarterectomy operations.
- Procedure performed under local anesthesia with continuous neurological monitoring.
- Use of temporary internal shunt based on neurological changes during test cross-clamping.
Main Results:
- No deaths within 30 days post-operation.
- Only 4.8% of patients experienced postoperative hypertension.
- Temporary shunts were used in three patients due to transient neurological changes during cross-clamping, with no resulting deficits.
Conclusions:
- Simple neurological monitoring of awake patients is effective in determining the need for an internal carotid shunt.
- Carotid endarterectomy under local anesthesia is a safe and viable option, particularly for elderly patients with comorbidities like hypertension and ischemic heart disease.