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Titolo:
ANESTHETIC METHODS IN REOPERATIVE CAROTID SURGERY
Autore:
ROCKMAN CB; RILES TS; LAMPARELLO PJ; GIANGOLA G; ADELMAN MA; JACOBOWITZ GR; LANDIS R; IMPARATO AM;
Indirizzi:
NYU,DEPT SURG,MED CTR,DIV VASC SURG,530 1ST AVE,SUITE 6F NEW YORK NY 10016
Titolo Testata:
Annals of vascular surgery
fascicolo: 2, volume: 12, anno: 1998,
pagine: 163 - 167
SICI:
0890-5096(1998)12:2<163:AMIRCS>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
TERM FOLLOW-UP; STENOSIS; MANAGEMENT; RESTENOSIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
19
Recensione:
Indirizzi per estratti:
Citazione:
C.B. Rockman et al., "ANESTHETIC METHODS IN REOPERATIVE CAROTID SURGERY", Annals of vascular surgery, 12(2), 1998, pp. 163-167

Abstract

It has been suggested that general anesthesia is the preferred methodfor reoperative carotid surgery for several reasons, including: the difficulty of the reoperative dissection; the disease may extend unusually high into the internal carotid artery; and the reconstruction required may be more complex than a typical endarterectomy. The purpose ofthis study is to show that reoperative carotid surgery can be performed safely under regional anesthesia. The records of 109 reoperative carotid operations performed on 96 patients over the past 25 years were reviewed. Procedures performed under regional anesthesia were comparedto those performed under general anesthesia with respect to patient characteristics, intraoperative courses, and perioperative results. Regional anesthesia was utilized in 79 operations (72.5%); 30 operations were performed with general anesthesia (27.5%). The two patient groupswere essentially equivalent with regard to atherosclerotic risk factors, preoperative neurologic symptoms, and the prevalence of contralateral total occlusion. The etiologies for recurrent disease included recurrent atherosclerosis (50.4%), intimal hyperplasia (30.3%), and vein patch aneurysm (9.2%). The methods of reconstruction employed includedsaphenous vein patch (47.7%), vein interposition graft (11.9%), prosthetic patch (20.2%), and prosthetic graft (20.2%). Perioperative strokes occurred in one case performed under regional anesthesia (1.3%), and in two cases under general anesthesia (6.6%); this difference was not statistically significant. Reoperative carotid artery surgery can beperformed under regional anesthesia safely in the majority of instances. The aforementioned theoretical factors in favor of general anesthesia could also lead to technical difficulties with intraarterial shuntinsertion. Having the patient awake, even if just long enough to prove that the patient will tolerate carotid artery clamping, might simplify many of these operations by avoiding shunt insertion. Regional anesthesia should therefore be considered an acceptable option in cases ofreoperative carotid surgery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 12:50:39