Perioperative Hypertension in Patients Undergoing Carotid Endarterectomy

Corson, John D.; Chang, Benjamin; Léopold, P; DeLeo, Bernard; Shah, Dhiraj M.; Leather, Robert P.; Karmody, Allastair M.

doi:10.1097/00132586-198706000-00033

Cited by 4 publications

(3 citation statements)

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“…5 Overall, 78% of the patients in this study who developed severe post-operative hypertension had preoperative hypertension. Similar results were found in uncontrolled hypertensives in the retrospective study performed by Corson et al 6 Skudlarick and Mooring prospectively studies 41 patients undergoing CEA. 7 All hypertensive patients in this series were controlled on medications preoperatively and post-operative systolic BP was pharmacologically maintained between 100-150 mmHg.…”

Section: Preoperative Hypertension Does Predict Post-carotid Endartersupporting

confidence: 85%

Preoperative Hypertension does Predict Post-Carotid Endarterectomy Hypertension

Gelb

Herrick

1990

Can. j. neurol. sci.

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Section: Preoperative Hypertension Does Predict Post-carotid Endartersupporting

confidence: 85%

Preoperative Hypertension does Predict Post-Carotid Endarterectomy Hypertension

Gelb

Herrick

1990

Can. j. neurol. sci.

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“…There is a very low incidence of cardiovascular complications of CAS with cervical block in comparison with GA with a decrease in the incidence of postoperative hypertension and reduction in the duration of hospital stay have been reported. [ 6 ] In experienced hands, sole use of CEA for various neck and chest surgeries is documented, highlighting the advantages such as stable cardio-respiratory status by avoiding airway instrumentation, less blood loss, and postoperative morbidity. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

A case of subclavian artery aneurysm with history of ischemic heart disease operated under cervical epidural anesthesia

et al. 2017

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Subclavian artery aneurysm is usually operated under general anesthesia (GA), but in specific situations, it can also be conducted under regional anesthesia (RA) such as cervical epidural anesthesia (CEA). A 48-year-old male presented with chief complaint of progressive swelling in the right side of the neck for the past 3 months following trauma. He was diagnosed as subclavian artery aneurysm, and surgical intervention was advised. He had previous history of angina 4 months back for which tablet aspirin 75 mg and tablet clopidogrel 75 mg once daily was prescribed. Cardiological evaluation revealed of an ejection fraction of around 30% with mild left ventricular hypokinesia and grade 2 diastolic dysfunction. Due to the poor cardiac functional status of the patient, RA with CEA was planned. The risk with GA in cases with a history of myocardial ischemia is more than RA, hence, it is better to use CEA which is equally efficacious in such high-risk cases.

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“…The patients' systolic blood pressure is maintained between 130 and 150 mmHg, and this often mandates the use of intravenous antihypertensives, either intermittently or as a continuous infusion. In addition, all of the carotid endarterectomy procedures are performed under general anesthesia, which has been suggested to exacerbate, tensify and lengthen postoperative hemody?amic Instability [13,17]. This may be another contnbutor to the authors' high incidence of postoperative hypertension that requires therapy.…”

Section: Discussionmentioning

confidence: 99%

Intensive Care is Cost-Effective in Carotid Endarterectomy

Ross,

Tribble,

Parrino

et al. 2000

Cardiovascular Surgery

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The purpose of this study was to analyze the utilization, cost profile, and predictors of intensive care unit (ICU) services after carotid endarterectomy. A retrospective medical record review of all patients undergoing isolated carotid endarterectomy by a vascular surgery service at one university hospital during a 12-month period was performed. Eighty-four patients undergoing 91 carotid endarterectomies were identified for review. All carotid endarterectomy patients at the authors' institution were routinely admitted to an ICU postoperatively. Sixty-five of the 91 patients (71.4%) required ICU interventions, the majority of which were intravenous antihypertensive therapy. There were no deaths in the group. There was one non-fatal stroke (1.1%), and one non-fatal myocardial infarction (1.1%). There were three reoperations (3.3%): two for hematoma and one for a change in neurological status. One patient required reintubation. Five of the six major adverse events after carotid endarterectomy occurred within 12 hours postoperatively. No preoperative factors predicted a significant risk for complications following carotid endarterectomy. There is no reliable predictor that carotid endarterectomy patients will require postoperative interventions or develop adverse outcomes. Mandatory intensive care immediately after carotid endarterectomy upholds high safety standards, avoids the uncertainty of preoperative ICU planning, and avoids the high cost of a recovery room stay to determine the need for intensive care. In addition, costs may be further reduced as the ICU length of stay may be decreased if there are no necessary interventions or complications after 12 hours of intensive care.

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Perioperative Hypertension in Patients Undergoing Carotid Endarterectomy

Cited by 4 publications

References 0 publications

Preoperative Hypertension does Predict Post-Carotid Endarterectomy Hypertension

Preoperative Hypertension does Predict Post-Carotid Endarterectomy Hypertension

A case of subclavian artery aneurysm with history of ischemic heart disease operated under cervical epidural anesthesia

Intensive Care is Cost-Effective in Carotid Endarterectomy

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