Comparison of eversion carotid endarterectomy under local anesthesia and eversion/conventional carotid endarterectomy under general anesthesia


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DEŞER S. B., ARAPİ B.

KARDIOCHIRURGIA I TORAKOCHIRURGIA POLSKA-POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, vol.20, no.1, pp.30-35, 2023 (ESCI) identifier identifier identifier

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.