Regional anesthesia for carotid surgery : An overview of anatomy, techniques and their clinical relevance.

CONCLUSIONS: With regional anesthetic techniques evolving to be more and more complex, the use of ultrasound is becoming increasingly indispensable in the operating theatre. For anesthesiologists with sufficient training and a profound knowledge of the respective anatomy, regional anesthesia seems to be a veritable alternative to general anesthesia for CEA. PMID: 28188324 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research

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Amit Nagpal, Mohit Mittal, Shalvi Mahajan, Adarsh C SwamiIndian Journal of Anaesthesia 2019 63(10):868-869
Source: Indian Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
A number of awake patients undergoing carotid endarterectomy (CEA) present from test clamp neurological deficits (NDs) during the procedure. Current guidelines advocate tighter Doppler ultrasound (DUS) surveillance in these patients because of probable higher likelihood of hemodynamic stroke (class 1 grade C), although evidence is lacking regarding benefit. The aim for the study is the assumption that patients who present ND have a higher risk of developing a complete stroke if the ipsilateral carotid artery becomes occluded, and for this reason, surveillance over restenosis of endarterectomy in this group is justifiable; ...
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research Source Type: research
A number of awake patients undergoing carotid endarterectomy (CEA) present from test clamp neurological deficits (ND) during the procedure. Current guidelines advocate tighter doppler ultrasound (DUS) surveillance in these patients due to probable higher likelihood of hemodynamic stroke (class 1 grade C), although evidence is lacking regarding benefit. the reasoning for the study is: the assumption that patients who present ND have a higher risk of developing a complete stroke if the ipsilateral carotid artery becomes occluded, and for this reason surveillance over restenosis of endarterectomy in this group is justifiable,...
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research
Ahmed Mohamed Elhfnawy1*, Peter U. Heuschmann2, Mirko Pham3†, Jens Volkmann1† and Felix Fluri1,4 1Department of Neurology, University Hospital Würzburg, Würzburg, Germany 2Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany 3Institute of Diagnostic and Interventional Neuroradiology, University Hospital of Würzburg, Würzburg, Germany 4Department of Neurology, Kantonssptial St. Gallen, St. Gallen, Switzerland Background and Purpose: Internal carotid artery stenosis (ICAS)≥70% is a leading cause of ischemic cerebrovascular event...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Nikolaos Patelis, Maria Diakomi, Anastasios Maskanakis, Konstantinos Maltezos, Dimitrios Schizas, Marianna PapaioannouSaudi Journal of Anaesthesia 2018 12(4):612-617 Anesthesia for carotid endarterectomy (CEA), general or locoregional, has been an issue of debate in literature ever since the first Cochrane review in 1991. The largest available study on the subject, the GALA trial, has not shown any difference in patient's outcome – incidence of stroke and 30-day-mortality postsurgery. However, increasing evidence favors regional anesthesia as an independent factor of reduced morbidity after CEA. The advantages a...
Source: Saudi Journal of Anaesthesia - Category: Anesthesiology Authors: Source Type: research
CONCLUSION: This study presents an ultrasound-guided subplatysmal block of the superficial ansa cervicalis for the first time, with the aim of optimizing anesthesia quality during surgical interventions in the carotid triangle. PMID: 30276418 [PubMed - as supplied by publisher]
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research
A 71 year old man presented with six episodes of right amaurosis fugax over the preceding month. He underwent an uncomplicated carotid endarterectomy under local anaesthesia. The image shows the rounded polyp on ultrasound and intra-operatively the plaque projecting into the lumen, distal to the 70 –79% stenosis at the right internal carotid artery origin. Histology was in keeping with an atheromatous plaque. Around 20% of carotid plaques are smooth, but unusually this was almost spherical. Current evidence suggests major plaque irregularities infer a greater risk of neurological events, in which case this polypoid l...
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Coup D ’Oeil Source Type: research
The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Abstract OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia. Systolic blood pressure (SBP) changes, anaesthetic and vasoactive agents, anal...
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Conclusions—Local anesthesia, patch plasty compared with primary closure, intraoperative completion studies by duplex ultrasound or angiography, and perioperative antiplatelet medication were independently associated with lower in-hospital stroke or death rates after carotid endarterectomy.
Source: Stroke - Category: Neurology Authors: Tags: Clinical Studies, Revascularization, Quality and Outcomes, Cerebrovascular Disease/Stroke, Atherosclerosis Original Contributions Source Type: research
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