eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2023
vol. 20
 
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abstract:
Original paper

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

Serkan Burc Deser
1
,
Berk Arapi
2

  1. Department of Cardiovascular Surgery, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
  2. Department of Cardiovascular Surgery, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
Kardiochirurgia i Torakochirurgia Polska 2023; 20 (1): 30-35
Online publish date: 2023/04/03
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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.

keywords:

carotid artery endarterectomy, eversion technique, conventional technique, stroke, hypertension

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