Our experience with carotid endarterectomy

Abstract

Stroke 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 and internal carotid artery exist. 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.A total of 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. Among 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. © 2017 OMU.