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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
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Fast-Track Protocol for Carotid Surgery.
Noemi Baronetto1,2, Stefano Brizzi1, Arianna Pignataro1,2
1Vascular Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy.
Journal of Clinical Medicine
|June 26, 2025
Summary
A new fast-track protocol for carotid endarterectomy (CEA) significantly reduces hospital stay and shows low complication rates. This approach enhances recovery for patients undergoing this common surgical procedure.
Area of Science:
- Vascular Surgery
- Surgical Protocols
- Patient Recovery
Background:
- Fast-track (FT) protocols aim to minimize surgical impact and improve recovery.
- Establishing FT protocols for carotid endarterectomy (CEA) is crucial.
- Carotid stenting offers a less invasive alternative, though its benefits are debated.
Purpose of the Study:
- To propose and evaluate a fast-track protocol for carotid endarterectomy (CEA).
- To analyze the clinical outcomes of CEA performed under a fast-track protocol.
Main Methods:
- Retrospective analysis of 853 patients undergoing CEA for asymptomatic stenosis (Jan 2016-Dec 2024).
- Protocol included same-day admission, local anesthesia, non-invasive assessments, and selective cervical drainage.
- Discharge criteria focused on absence of pain, hemodynamic instability, and complications.
Main Results:
- Mean length of hospital stay was 1.17 days.
- Low complication rates: 0.4% minor stroke, 0.2% myocardial infarction.
- Postoperative pain control was adequate in 99.4% of patients (NRS <= 4).
Conclusions:
- The developed fast-track protocol for elective carotid surgery is associated with a low complication rate.
- The protocol demonstrates clinical value, warranting further validation via comparative studies.
- Comparative medico-economic research is recommended for implementing FT protocols in carotid surgery.
