Our experience with Carotid Endarterectomy
Our experience with Carotid Endarterectomy
IntroductionStroke is the second
most common cause of cardiovascular mortality. Atherosclerosis is the most
common cause of carotid artery stenosis. The most common site is carotid
bifurcation where the carotid baroreceptors exist and internal carotid artery. The
primary objective of carotid surgery is to protect the brain from an ischemic
damage. In this study, we evaluated early and mid term result of 24 patients
who had undergone unilateral carotid endarterectomy surgery.Patients,
materials and methodsA total of 24 patients (17 males, 7 females; mean age
68.62 years; ranges from 55 to 91 years) who underwent CEA operations between
January 2015 and january 2017 were retrospectively analyzed. Postoperative
complications (neurological and non-neurological) and mortality were the
primary outcome points in the study. Clinical findings and risk factors were
evaluated.ResultsAmong the seven of the
24 NIRS monitored patients (5 males, 2 females; mean age 65.8 years; range 60
to 75 years), a significant decrease in cerebral SO2 was observed during
clamping of the common carotid artery. For this reason we decided to use
intracarotid shunt. We observed that the cerebral oximetry values were
increased after the use of a shunt in these seven cases. Discussion
NIRS monitoring is a
precious tool which provides vital information and is used to determine whether
a shunt is needed during CEA surgery. The present study showed that carotid
endarterectomy under general anesthesia accompanying NIRS, measurement of the
stump pressure and usage of dacron patch material can be performed with
acceptable mortality and morbidity.
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