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Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia / 대한흉부외과학회지
The Korean Journal of Thoracic and Cardiovascular Surgery ; : 392-399, 2019.
Artigo em Inglês | WPRIM | ID: wpr-786668
ABSTRACT

BACKGROUND:

The surgical strategies for carotid endarterectomy (CEA) vary in terms of the anesthesia method, neurological monitoring, shunt usage, and closure technique, and no gold-standard procedure has been established yet. We aimed to analyze the feasibility and benefits of CEA under regional anesthesia (RA) and CEA under general anesthesia (GA).

METHODS:

Between June 2012 and December 2017, 65 patients who had undergone CEA were enrolled, and their medical records were prospectively collected and retrospectively reviewed. A total of 35 patients underwent CEA under RA with cervical plexus block, whereas 30 patients underwent CEA under GA. In the RA group, a carotid shunt was selectively used for patients who exhibited negative results on the awake test. In contrast, such a shunt was used for all patients in the GA group.

RESULTS:

There were no cases of postoperative stroke, cardiovascular events, or mortality. Nerve injuries were noted in 4 patients (3 in the RA group and 1 in the GA group), but they fully recovered prior to discharge. Operative time and clamp time were shorter in the RA group than in the GA group (119.29±27.71 min vs. 161.43±20.79 min, p<0.001; 30.57±6.80 min vs. 51.77±13.38 min, p<0.001, respectively). The hospital stay was shorter in the RA group than in the GA group (14.6±5.05 days vs. 18.97±8.92 days, p=0.022). None of the patients experienced a stroke or restenosis during the 27.23±20.3-month follow-up period.

CONCLUSION:

RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Artérias Carótidas / Prontuários Médicos / Estudos Prospectivos / Estudos Retrospectivos / Seguimentos / Mortalidade / Endarterectomia das Carótidas / Acidente Vascular Cerebral / Endarterectomia / Duração da Cirurgia Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: The Korean Journal of Thoracic and Cardiovascular Surgery Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Artérias Carótidas / Prontuários Médicos / Estudos Prospectivos / Estudos Retrospectivos / Seguimentos / Mortalidade / Endarterectomia das Carótidas / Acidente Vascular Cerebral / Endarterectomia / Duração da Cirurgia Tipo de estudo: Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: The Korean Journal of Thoracic and Cardiovascular Surgery Ano de publicação: 2019 Tipo de documento: Artigo