Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?

Aim: Surgical strategies in carotid endarterectomy (CEA) vary according to the method of anesthesia, neurological monitoring, shunt use, and closure methods, and the gold standard method has not yet been determined. In this study, we aimed to analyze the superiority and feasibility of CEA under gene...

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Main Authors: Fehim Can Sevil, Serkan Gume, Mehmet Tort, Necip Becit
Format: Article
Language:English
Published: Turkish National Vascular and Endovascular Surgery Society 2024-03-01
Series:Turkish Journal of Vascular Surgery
Subjects:
Online Access:https://turkishjournalofvascularsurgery.org//?mno=187580
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author Fehim Can Sevil
Serkan Gume
Mehmet Tort
Necip Becit
author_facet Fehim Can Sevil
Serkan Gume
Mehmet Tort
Necip Becit
author_sort Fehim Can Sevil
collection DOAJ
description Aim: Surgical strategies in carotid endarterectomy (CEA) vary according to the method of anesthesia, neurological monitoring, shunt use, and closure methods, and the gold standard method has not yet been determined. In this study, we aimed to analyze the superiority and feasibility of CEA under general anesthesia and regional anesthesia. Material and Methods: Demographic characteristics, operative information and follow-up results of 237 patients who underwent CEA between January 2015 and June 2020, 165 patients under regional anesthesia (RA: Group 1) and 72 under general anesthesia (GA: Group 2), were retrospectively analyzed. In Group 1, carotid shunt was placed in patients with a negative awake test (n: 21, 12.7%) and in Group 2 carotid shunt was placed in all cases. Results: There was no statistically significant difference in postoperative stroke, transient ischemic attack (TIA) and cardiovascular mortality (p: 0.48; p: 0.30; p: 0.63, respectively). Although the operation and clamp time were shorter in Group 1, no significant difference was observed (97.93±11.02 min, 101.46±9.49 min p: 0.23; 19.60±5.62 min, 25.62±7.47 min p: 0.24, respectively). The duration of intensive care unit (ICU) stay was shorter and statistically significant in Group 1. (p: 0.003). There was no significant difference for restenosis rates (p: 0.34). Conclusion: There was no significant increase in postoperative complications in the RA group compared to the GA group despite shunting according to the awake test. Also, patients who underwent RA stayed in ICU for a shorter period of time. CEA can be performed under both GA and RA with similar complication rates. [Turk J Vasc Surg 2024; 33(2.000): 71-77]
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spelling doaj-art-ac2afcb9cd6643268b27ad7c6848c0ac2025-02-11T11:13:53ZengTurkish National Vascular and Endovascular Surgery SocietyTurkish Journal of Vascular Surgery2667-50802024-03-013327177187580Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?Fehim Can Sevil0Serkan Gume1Mehmet Tort2Necip Becit3Assoc. Prof. Dr. Asst. Prof. Dr. Assoc. Prof. Dr. Prof. Dr.Aim: Surgical strategies in carotid endarterectomy (CEA) vary according to the method of anesthesia, neurological monitoring, shunt use, and closure methods, and the gold standard method has not yet been determined. In this study, we aimed to analyze the superiority and feasibility of CEA under general anesthesia and regional anesthesia. Material and Methods: Demographic characteristics, operative information and follow-up results of 237 patients who underwent CEA between January 2015 and June 2020, 165 patients under regional anesthesia (RA: Group 1) and 72 under general anesthesia (GA: Group 2), were retrospectively analyzed. In Group 1, carotid shunt was placed in patients with a negative awake test (n: 21, 12.7%) and in Group 2 carotid shunt was placed in all cases. Results: There was no statistically significant difference in postoperative stroke, transient ischemic attack (TIA) and cardiovascular mortality (p: 0.48; p: 0.30; p: 0.63, respectively). Although the operation and clamp time were shorter in Group 1, no significant difference was observed (97.93±11.02 min, 101.46±9.49 min p: 0.23; 19.60±5.62 min, 25.62±7.47 min p: 0.24, respectively). The duration of intensive care unit (ICU) stay was shorter and statistically significant in Group 1. (p: 0.003). There was no significant difference for restenosis rates (p: 0.34). Conclusion: There was no significant increase in postoperative complications in the RA group compared to the GA group despite shunting according to the awake test. Also, patients who underwent RA stayed in ICU for a shorter period of time. CEA can be performed under both GA and RA with similar complication rates. [Turk J Vasc Surg 2024; 33(2.000): 71-77]https://turkishjournalofvascularsurgery.org//?mno=187580carotid arteriesendarterectomyregional anesthesia
spellingShingle Fehim Can Sevil
Serkan Gume
Mehmet Tort
Necip Becit
Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
Turkish Journal of Vascular Surgery
carotid arteries
endarterectomy
regional anesthesia
title Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
title_full Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
title_fullStr Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
title_full_unstemmed Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
title_short Carotid endarterectomy outcomes according to anesthesia method: General anesthesia or regional anesthesia?
title_sort carotid endarterectomy outcomes according to anesthesia method general anesthesia or regional anesthesia
topic carotid arteries
endarterectomy
regional anesthesia
url https://turkishjournalofvascularsurgery.org//?mno=187580
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AT serkangume carotidendarterectomyoutcomesaccordingtoanesthesiamethodgeneralanesthesiaorregionalanesthesia
AT mehmettort carotidendarterectomyoutcomesaccordingtoanesthesiamethodgeneralanesthesiaorregionalanesthesia
AT necipbecit carotidendarterectomyoutcomesaccordingtoanesthesiamethodgeneralanesthesiaorregionalanesthesia