Operativno zdravljenje zožitve (endarterektomija) notranje karotide v lokalni anesteziji
Internal carotid endarterectomy under local anaesthesia

slovenian

2004

volume 73, issue 12

Anesthesia, Local   Carotid Artery, Internal   Carotid Stenosis   Endarterectomy, Carotid   therapy   Treatment Outcome

Slovensko zdravniško društvo
(Obvezni izvod spletne publikacije)

Background. Endarterectomy of the internal carotid artery, supported by medicamental treatment, is the best method used to prevent stroke with symptomatic patients with an over 70-percent narrowing of the ipsilateral carotid artery. With patients who have successfully passed the operation the occurrence of the stroke is less oftert than with non-operated patients (1% vs. 6-10% per year). Therefore, it is important that the operation is carried out as safely as possible. Currently; the average acceptahle rate of death and/ or severe stroke risk stands at between 2-4%. Greatest problems faced during carotid artery surgery are embolism of the affected artery during preparation, brain ischaemia during the blockade of the carotid artery, and embolism and intimal tearing due to injury of the internal carotid artery by the temporary internal shunt. Due to the risk of causing an embolism and intimal tearing the use of the internal shunt cau be dangerous. Therefore, selective usage of the shunt is recommended when necessary due to brain ischaemia. Methods. Under block/conduction anaesthesia (deep and superficial cervical block) we have performed surgery on 23 patients (16 males, 7 females)because of severe stenosis of the internal carotid artery (over 70%). A mixture of Xylocain 1% and Marcain 1.5% was used for the cervical block. Cerebral blood circulation was monitored by neurological testing of thepatientawake during the procedure. During the procedure, we performed standard monitoring of the vital functions including the blood pressure. Additionally, the transcranial Doppler monitoring of the blood flow through the middle cerebral artery was used with 20 of the patients. (Abstract truncated at 2000 characters)

10.04.2014