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Carotid endarterectomy under local anesthesia: single institutional experience

Yusuf Kalko^a,*, Unal Aydin^a, Yusuf Bayrak^b, Ülkü Kafa^a, Taylan Kösker^a, Murat Basaran^a, Zehra Yangn^c and Tahsin Yasar^a

^a Department of Cardiovascular Surgery, SB Vakf Gureba Hospital, Capa, 34390, Istanbul, Turkey
^b Department of Thoracic Surgery, VKV American Hospital, Istanbul, Turkey
^c Department of Anesthesiology, Vakf Gureba Hospital, Istanbul, Turkey

*Corresponding author. Tel.: +90 532 345 21 61; fax: +90 212 621 7580.

E-mail address: ykalko{at}mynet.com (Y. Kalko).

The aim of this study is to review our experience and results of carotid endarterectomy performed under local anesthesia. We evaluated 300 patients who had undergone carotid endarterectomy with local anesthesia in our department. Surgical indication, outcome, operative technique, and complications were assessed. The patients were 58.20±2.76 years old and 153 (51%) were symptomatic. The perioperative course was uneventful. A shunt was inserted because of neurological deterioration in 20 patients (6.6%) with full recovery of the deficit after shunt insertion. Operative time was 52.02±12.86 min. There were 9 patients with postoperative neurological complications with one patient who died after 34 days. The remaining 8 patients with reversible neurological deficits recovered and were symptom-free on discharge. The mean length of hospital stay was 2.11±1.34 days. Carotid endarterectomy performed under local anesthesia is associated with low morbidity and mortality rates. The surgeon can assess the neurological status during the procedure and provide for a more meticulous endarterectomy. It is also associated with decreased shunt usage, decreased operative time and shorter length of hospital stay.

Key Words: Carotid endarterectomy; Local anesthesia; Awake patient