Xenon Anesthesia: Is it in Due Course for a Mainstream Comeback?
HISTORICALLY, carotid endarterectomy (CEA) surgery has generated several disputes regarding the choice of anesthesia provided and intraoperative neuromonitoring. The landmark General Anesthesia versus Local Anesthesia trial,1 which included 3,526 patients, showed no difference in the occurrence of stroke, myocardial infarction, or death at 30 days after surgery with respect to either local or general anesthesia. Harky et al.2 conducted a systematic review and meta-analysis of general versus local anesthesia in CEA surgery and concluded that each of the anesthetic techniques was noninferior to one another.
CONCLUSIONS: Routine delayed shunting associated with standardisation of the technique seems to be a safe and effective technique and contributes to maintaining the RNCR
CONCLUSIONS: GAPC associated with sequential carotid cross-clamping appeared to be safe and effective in prevention of major neurological and cardiologic complications during CEA. PMID: 29633744 [PubMed - in process]
Simultaneous coronary artery bypass grafting and carotid endarterectomy (CABG/CEA) includes two different surgical operations doing by two teams of operating surgeons during one anaesthetic support. Patients with concomitant coronary and carotid artery disease stay in group of high risk of perioperative acute stroke and myocardial infarction, and therefore conducting of simultaneous CABG/CEA can reduce the incidence of late myocardial infarction and postoperative stroke in this group of patients and can improve survival in the long-term period.
Publication date: Available online 31 March 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Katherine Livingstone, Indran Raju Carotid endarterectomy (CEA) is a surgical procedure to prevent strokes in patients with atheromatous disease at the carotid bifurcation. The effectiveness of CEA has been established in large clinical trials. Patients should have surgery performed within 2 weeks from the onset of symptoms. This time frame presents a challenge to the anaesthetist and surgeon in risk stratifying and optimizing patients for surgery. Optimization includes blood pressure (BP) control and use of ant...
Carotid endarterectomy (CEA) is usually performed under general anesthesia (GA), although some advocate regional anesthesia (RA) to reduce hemodynamic instability and allow neurologic monitoring and selective shunting. RA does not reduce risk of periprocedural stroke or death, although some series show a reduction in myocardial infarction (MI). We investigated the association of anesthesia type and periprocedural MI among patients receiving GA or RA for CEA and patients undergoing carotid artery stenting (CAS) in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST).
Conclusion According to our experiences and results, the simultaneous performance of CEA and CABG in patients with severe coexisting carotid artery disease who require coronary revascularization has proved to be a safe and efficacious operative strategy in these high-risk patients.
Conclusion: Combining CEA along with CABG is a safe and effective procedure.
CONCLUSIONS: Increasing diastolic blood pressure was the only independent risk factor for stroke, MI, or death following CEA. Cautious attention to blood pressure control following symptoms attributable to carotid stenosis could reduce the risks associated with subsequent CEA. PMID: 26460291 [PubMed - as supplied by publisher]
Most carotid endarterectomy (CEA) procedures are performed under general anesthesia (GA), although some advocate regional anesthesia (RA) to reduce hemodynamic instability and allow neurologic monitoring and selective shunting. RA does not reduce the risk of periprocedural stroke or death, although some series show a reduction in myocardial infarction (MI). The incidence of periprocedural MI, death, and stroke was compared in the surgical cohort of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) between patients undergoing CEA under GA or RA, as well as the carotid artery stenting (CAS) cohort.
Carotid endarterectomy (CEA) is the most commonly performed surgical procedure to reduce risk of stroke. The operation may be performed under regional (RA) or general anesthesia (GA). Despite perceived advantages of RA, previous trials have found no difference in incidence of transient ischemic attack, stroke, myocardial infarction (MI), and death with RA compared with GA. A retrospective review was performed to determine if postoperative outcomes were influenced by gender or the type of anesthesia used, or both.