Is Routine Intravascular Shunting Necessary for Carotid Endarterectomy in Patients with Contralateral Occlusion? A Review of 5-Year Experience of Carotid Endarterectomy with Local Anaesthesia

Çınar, Bayer; Göksel, Onur; Karatepe, Celalettin; Kut, Sinan; Aydogan, Hakki; Filizcan, Uğur; Cetemen, Sebnem; Çoruh, Türkan; Eren, Ergin

doi:10.1016/j.ejvs.2004.07.010

Cited by 26 publications

(21 citation statements)

References 10 publications

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“…8,9 Routine or selective use of an intraluminal shunt during CEA has been reported to be effective for avoidance of this risk. 45,46 CAS also requires shorter temporary occlusion during the procedure. On the basis of a system- atic review of 206 independent studies of 54,713 patients who received CAS, Touzé et al 47 found that CAS contralateral to carotid occlusion does not increase the operative risk.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamic Benefits after Contralateral Carotid Artery Stenting in Patients with Internal Carotid Artery Occlusion

Oka

Ishihara

Kato

et al. 2012

AJNR Am J Neuroradiol

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SUMMARY:CEA contralateral to an ICA occlusion is considered a surgical risk, and CAS may be an alternative for these patients. Our goal was to examine whether CAS improves cerebral hemodynamics on the treated side and on the side of the ICA occlusion, on the basis of measurement of CBF and CVR by using SPECT. The subjects were 8 patients who underwent contralateral CAS. Resting CBF and CVR to acetazolamide were measured by using 123 I-IMP SPECT before and chronically (3-6 months) after CAS. Resting CBF was also measured immediately (Ͻ2 hours) after CAS by using 123 I-IMP SPECT. There were no significant differences in resting CBF in both hemispheres

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Section: Discussionmentioning

confidence: 99%

Cerebral Hemodynamic Benefits after Contralateral Carotid Artery Stenting in Patients with Internal Carotid Artery Occlusion

Oka

Ishihara

Kato

et al. 2012

AJNR Am J Neuroradiol

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“…Due to endothelial dissection of the vessel, the shunt presents a higher risk of severe injury to the intima at the insertion point and a greater probability of thrombosis in the operated area; they can also increase the technical difficulty of the procedure (visualization of the plaque), causing an increase in the arteriotomy and can, also, increase the risk of aerial and atherothrombotic embolization, due to the greater handling of the artery [12,16,17].…”

Section: Ga -General Anesthesiamentioning

confidence: 99%

Endarterectomia de carótida em paciente acordado

Santos¹,

Fabri²,

Cunha³

et al. 2006

Rev Bras Cir Cardiovasc

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Objective: To evaluate morbidity and mortality of carotid endarterectomy performed under regional cervical block, taking into account duration of surgery, use of shunt, conversion to general anesthesia, surgical complications, stay of patients in the intensive care unit (ICU) and in the hospital, and patients' evolution over one year. 63 SANTOS, PC ET AL -Carotid endarterectomy in conscious patientBraz J

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“…Using a carotid shunt helps to perform a safer surgical intervention [23][24][25]. There are disadvantages such as particle embolization associated with carotid shunt use [26].…”

Section: Intraoperative Data Numbermentioning

confidence: 99%

A New Approach to Myocardial Revascularization in Patients with Severe Carotid Lesions: Simultaneous Cardiopulmonary Bypass and Local Carotid Endarterectomy

Teker¹

2017

J Cardiovasc Dis Diagn

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Aim: In the present study, we aimed to present the retrospective outcomes of the patients who underwent carotid endarterectomy under local anesthesia followed by cardiopulmonary bypass under general anesthesia during the same session.Material and methods: 52 patients (36 male, 16 female patients; mean age was 69.0 ± 8.5 years: range 42 to 75 years) with carotid lesions underwent carotid endarterectomy under local anesthesia and simultaneous cardiopulmonary bypass between 1 st March 2015 and 1 st March 2016 in our center. This study involved patients with myocardial revascularization and 80% or more carotid stenosis (with or without contralateral disease). Preoperative, preoperative and postoperative characteristics of the patients were retrospectively analyzed.Results: Operative mortality rate was 1.9% with one patient. Early postoperative revision was performed in 3 patients (5.7%) bleeding. Postoperative atrial fibrillation developed in 6 patients (11.5%). There was no cerebrovasculary accident postoperatively. Conclusion:The incidence of coronary and carotid artery disease coexistence is not too low. The combined approach increases the stroke and mortality rate by using general anesthesia in the procedure, although the odds of complications appearing to reduce the duration of hospitalization with the performance of a single seansta procedure. In this study, we reported that local carotid artery intervention and simultaneous coronary artery bypass surgery reduced the stroke risk and mortality rates.

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Is Routine Intravascular Shunting Necessary for Carotid Endarterectomy in Patients with Contralateral Occlusion? A Review of 5-Year Experience of Carotid Endarterectomy with Local Anaesthesia

Cited by 26 publications

References 10 publications

Cerebral Hemodynamic Benefits after Contralateral Carotid Artery Stenting in Patients with Internal Carotid Artery Occlusion

Cerebral Hemodynamic Benefits after Contralateral Carotid Artery Stenting in Patients with Internal Carotid Artery Occlusion

Endarterectomia de carótida em paciente acordado

A New Approach to Myocardial Revascularization in Patients with Severe Carotid Lesions: Simultaneous Cardiopulmonary Bypass and Local Carotid Endarterectomy

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