Carotid Endarterectomy using Regional Anesthesia: Technique and Considerations.

Abstract

BACKGROUND Carotid endarterectomy (CEA) is one of the most effective neurosurgical operations in minimizing stroke risk in both symptomatic and asymptomatic patients with carotid stenosis. Awake CEA with regional anesthesia may decrease both perioperative complications and length of hospital stay. The awake carotid operation is not often described in published literature. OBJECTIVE To describe our experience with carotid endarterectomy using regional anesthesia with a focus on patient selection, anatomic variations, and surgical technique including cervical regional block. We particularly focus on nuances of the awake approach. METHODS Carotid endarterectomy using regional anesthesia is described in detail. RESULTS Successful use of regional anesthesia during carotid endarterectomy without complication. CONCLUSION Regional anesthesia for CEA is an advantageous approach for cervical plaque removal in appropriate patients. Thoughtful patient selection, as well as understanding of anatomy and its variants, is required. Potential advantages and disadvantages are discussed.