Comparison of eversion carotid endarterectomy under local anesthesia and eversion/conventional carotid endarterectomy under general anesthesia.
KARDIOCHIRURGIA I TORAKOCHIRURGIA POLSKA = POLISH JOURNAL OF CARDIO-THORACIC SURGERY 2023;
20:30-35. [PMID:
37077466 PMCID:
PMC10107416 DOI:
10.5114/kitp.2023.126096]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/27/2023] [Indexed: 04/21/2023]
Abstract
Introduction
Studies searching outcomes of eversion carotid endarterectomy (E-CEA) under local anesthesia are lacking.
Aim
To evaluate the postoperative outcomes of E-CEA under local anesthesia and compare it with E-CEA/Conventional CEA under general anesthesia in symptomatic or asymptomatic patients.
Material and methods
From February 2010 to November 2018 a total of 182 patients (143 males, 39 females; mean age: 69.69 ±9.88 years; range: 47 to 92 years) who underwent eversion CEA or conventional CEA with patchplasty under general or local anesthesia in two tertiary centers were included in this study.
Results
Overall in-hospital stay (p = 0.01), postoperative in-hospital stay (p = 0.022) took significantly less time in favor of E-CEA under local anesthesia. Overall, 6 patients developed major stroke (3.2%), among them 4 (2.1%) patients passed away, 7 (3.8%) patients developed cranial nerve injury (the marginal mandibular branch of the facial nerve and hypoglossal nerve), 10 (5.4%) patients developed a hematoma in the postoperative period. No difference was found in terms of postoperative stroke (p = 0.470), postoperative death (p = 0.703), postoperative bleeding rate (p = 0.521) or postoperative cranial nerve injury (p = 0.481) between the groups.
Conclusions
The mean operation time, postoperative in-hospital stay, overall in-hospital stay, and need for shunting were lower in patients who underwent E-CEA under local anesthesia. E-CEA under local anesthesia seemed to do better in stroke, death, and bleeding rate, however, this difference was not significant.
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