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Page 100
May 24-25, 2018
London, UK
Vascular Surgery 2018
3
rd
Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Background:
Carotid artery stenosis accounts for approximately
10% of all ischemic strokes, causing significant morbidity and
mortality. The use of local anaesthesia rather than general
anaesthesia might lower the risk of a stroke during or after
surgery. We investigated peri-operative outcomes of carotid
endarterectomy (CEA) done under local anaesthesia at our unit.
Methods:
Consecutive patients from a single vascular unit
with symptomatic carotid stenosis undergoing CEA under local
anaesthesia between January 2016 and October 2017 identified
from a prospective maintained vascular database were included
in the study.
Results:
Seventy-nine patients, who had CEA between January
2016 and October 2017, were included in the study. Amaurosis
fugax was the index event in 10% of patients (n=8), TIA in 46%
(n=36), minor stroke in 39% (n=31), other symptoms in 40% (n=3)
and asymptomatic in 1.0% (n=1). There were 65% (n=51) male
and 35% (n=28) female patients with a mean age of 74 years. Pre-
operative risk factors were age more than 80 years old (26.5%),
arterial hypertension (51.8%), hypercholesterolemia (83.5%),
current smoking (20%), ex smoking (55%), stenosis ≥90% (31.6%).
Majority of the patients were referred by stroke physicians (91%).
Operative procedure suture with prosthesis patch was 96.3%,
direct suture 2.5% and eversion 1.2%. Readmission within 30 days
of procedure was 3 (3.7%) patients. Repeat TIA were seen in 4
(5%) patients which recovered and no major stroke seen. There
was no cranial nerve injury and mortality in our study.
Conclusion:
Our evidence suggests that carotid endarterectomy
can be safely performed under local anaesthesia and can be an
effective alternative to general anaesthesia for carotid stenosis.
Recent Publications
1. Lewis S C, Warlow C P, et al. (2008) General anaesthesia
versus local anaesthesia for carotid surgery (GALA):
a multicenter randomized controlled trial. Lancet
372(9656):2132-2142.
2. Liu S S, Strodtbeck WM, Richman JMandWu C L (2005)
A comparison of regional versus general anaesthesia for
ambulatory anaesthesia: a meta-analysis of randomizes
controlled trials. Anesth Anal 101(6):1634-1642.
3. Rerkasem K and Rothwell P M (2008) Local versus
general anaesthesia for carotid endarterectomy.
Cochrane Database Syst Rev 4:CD00126.
4. Kfoury E, Patel S and Mukherjee D (2012) Carotid
endarterectomy under local anaesthesia: an alternative
treatment for carotid stenosis. Vasc Disease
Management 9(11):193-197.
5. Amato B, Markabaoui A K, et al. (2005) Carotid
endarterectomy under local anaesthesia in elderly: is it
worthwhile? Acta Biomed 76:64-68.
Biography
Sanjay Singh has expertise and passion in Vascular and Endovascular Sur-
gery. He has done complex aortic endovascular fellowship and is a Vascular
Consultant working in United Kingdom. His open and contextual surgical
techniques are based on researched and practiced models which help cre-
ate new pathways for innovation. He has achieved this aptitude after years
of experience in research and teaching in university hospitals and institu-
tions. The ever-responsive and adapting field of endovascular surgery has
improved the survival rates of high risk patients.
dr_sanjaysingh@hotmail.comCarotid endarterectomy under local anaesthesia: review of
practice and peri-operative outcomes
Sanjay Singh, Asghar Butt
and
Peter LeeChong
United Lincolnshire Hospitals NHS Trust, UK
Sanjay Singh et al., J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-003