Abstract
INTRODUCTION:Carotid endarterectomy is the gold standard for reducing the incidence of ischemic stroke in patients with symptomatic or severe carotid atherosclerosis. However, the procedure requires the interruption of cerebral blood flow by the internal carotid, this can result in inadequate cerebral perfusion and a perioperative cerebrovascular event.
OBJECTIVE:To determine the incidence of peri-operative cerebrovascular events, mortality and complications, as well as hospital stay, in patients undergoing carotid endarterectomy at the Hospital de San José de Bogotá. We also compared the benefit of using local anesthesia vs general anesthesia in patients taken to this surgical procedure to reduce the risk of cerebrovascular events
METHODOLOGY:Study of a retrospective cohort of patients undergoing carotid endarterectomy between November 2006 and November 2017.
RESULTS:32 patients were taken to a carotid endarterectomy of which 12 (37.5 %) were under general anesthesia and 20 (62.5 %) were under regional anesthesia, the incidence of global CVD was 15.6 %. Twelve patients (37.5 %) required a shunt with an incidence of cerebral stroke in patients in whom a shunt of 33.3 % was used. 5 % in those that were not used. Overall mortality and complications were 3.1 % and median hospital stay in patients under general anesthesia for 4 days (RIQ: 3.5-8.5) versus regional anesthesia 2.5 days (RIQ: 2-7.5).
CONCLUSIONS:According to the experience in the hospital of San José de Bogotá, there is a lower incidence of cerebrovascular events, in the perioperative period, a lower mortality rate, a hospital stay and in the lower intensive care unit in patients undergoing carotid endarterectomy under regional anesthesia.
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