Local anesthesia: serious consideration for extracranial carotid artery surgery

Local anesthesia for extracranial carotid artery surgery presents an alternative to the methods currently used today. It does eliminate the necessity for complicated and expensive monitoring equipment. It has the advantage that both the surgeon and the anesthesiologist are aware at all times of the level of cerebral activity of the patient. The advantages and disadvantages of this technique are discussed. From an academic viewpoint, it gives the surgeon the ability to exactly determine in his intraoperative complications those cases in which cerebral infarction is due to embolization and those which could occur from inadequate collateral circulation.