Procedures on Internal Carotid Performed Under Locoregional Anesthesia in the Plzeň Surgical Clinic, Over a Seven-Year Period. A Discussion on AHA and ESVS Guidelines

Czech version

Authors: B. Čertík; V. Třeška; J. Křižan; R. Šulc; M. Čechura; V. Kuntscher; J. Moláček
Authors‘ workplace: Chirurgická klinika FN Plzeň-Lochotín, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in: Rozhl. Chir., 2010, roč. 89, č. 1, s. 4-8.
Category: Monothematic special - Original

Overview

During a seven-year period (2002–2008), 830 patients underwent internal carotid surgery in the Plzeň Surgical Clinic. The mean age of the patients was 68 y.o.a. (range 48–86 years). A total of 916 internal carotid procedures were performed, the male/female ratio was 667/249. 639 procedures were performed for asymptomatic and 277 for symptomatic conditions. 677 patients suffered from unilateral carotid disorders and 153 subjects from bilateral carotid disorders. All the procedures were performed under locoregional anesthesia. The 30-day mortality rate was 1% (9 subjects) of all the procedures.

Key words:
internal carotid artery – endarterectomy – cerebral ischemia stroke

Sources

1. AHA Scientific Statement 1998 Guidelines for Carotid Endarterectomy

2. MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group. Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. The Lancet, 2004, 363, p. 1491–1502.

3. Toole, J. F. Surgery for carotid artery stenosis. BMJ 2004, 329, p. 635–636.

4. ESVS Guidelines. Invasive Treatment for karotid Stenosis: Indications, techniques. Eur. J. Vasc. Endovasc. Surg., 2009, 37, p. 1–19.

5. Čertík, B., a kol. Onemocnění karotid a velkých cév aortálního oblouku. Grada Publishing, 2005, p. 61–65.

6. Mas, J.-L., et al. for the EVA-3S Investigators Endarterektomy versus stenting in patiens with symptomatic severe karotid stenosis. N. Eng. J. Med., 2006, 355, p. 1660–1671.

7. SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus karotid endarterectomy in symptomatic patiens: A randomised non-inferiority trial. Lancet, 2006, 368, p. 1239–1247.

8. Cao, P., Giordano, G., De Rango, P., Zannetti, S., Chiesa, R., Coppi, G., Palombo, D., Peinetti, F., Spartera, C., Stancanelli, V., Vecchiati, E., Collaborators of the EVEREST Study Group Eversion versus conventional carotid endarterectomy: Late results of a prospective multicenter randomized trial. J. Vasc. Surgery, 2000, 31, p. 19–30.

9. Katras, T., Baltazar, U., Rush, D. S., Sutterfield, W. Ch., Harvill, L. M., Stanton, P. E. Durability of eversion carotid endarterectomy: Comparison with primary closure and carotid patch angioplasty. J. Vasc. Surgery, 2001, 34, p. 453–458.

10. Illky, K. A., Shortell, C. K., Zhang, R., Sternbach, Y., Rhodes, J. M., Davies, M. G., Ouriel, K., Tansky, W., Johansson, M., Green, R. M. Carotid endarterectomy then and now: outcome and cost-effectiveness of moderne practice. Surgery, 2003, 134, p. 705–712.

11. Sternbach, Y., Illing, K. A., Zhang, R., Shortell, C. K., Rhodes, J. M., Davies, M. G., Lyden, S. P., Green, R. M. Hemodynamic benefits of regional anesthesia for carotid endarterectomy. J. Vasc. Surg., 2002, 35, p. 333–339.