Document Detail


Carotid endarterectomy under regional anaesthesia at Dunedin Hospital, New Zealand: 1994-2003.
MedLine Citation:
PMID:  16532048     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Carotid endarterectomy (CEA) under local or regional anaesthesia is being considered more often by vascular surgeons to improve cerebral monitoring and to reduce general anaesthetic complications. The purpose of this study was to audit the results of CEA under regional anaesthesia in a New Zealand hospital (Dunedin Hospital, Otago Province). METHODS: All carotid endarterectomies performed consecutively by one surgeon under regional anaesthesia over a 9-year period from November 1994 were reviewed. The cases and early complications were identified from a computerised audit database with prospective data input and all case notes were retrospectively reviewed for demographic data, comorbidity, the primary endpoints of stroke or death, and other complications of CEA. General practitioners and neurologists were contacted where follow-up information was incomplete. RESULTS: During the review period, 135 CEAs were performed in 132 patients. The need for shunting was accurately predicted in all but one patient. The stroke rate was 0.7% and 30-day mortality rate 0.7% thus giving a combined risk of stroke or mortality of 1.4%. No patient had a myocardial infarction in the perioperative period despite 46% of the patients having ischaemic heart disease. There were 10 late deaths over the 9-year period of review. CONCLUSION: CEA under regional anaesthesia is a safe operation even in patients with coronary disease and in a low volume setting. Moreover, it allows monitoring of cerebral ischaemia and the safe use of selective shunting. The results are comparable to other recently published series and provide a baseline for comparison with newer treatment modalities.
Authors:
Ian Thomson; Medhat Fanous
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Publication Detail:
Type:  Journal Article     Date:  2006-03-10
Journal Detail:
Title:  The New Zealand medical journal     Volume:  119     ISSN:  1175-8716     ISO Abbreviation:  N. Z. Med. J.     Publication Date:  2006  
Date Detail:
Created Date:  2006-03-13     Completed Date:  2006-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401067     Medline TA:  N Z Med J     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  U1882     Citation Subset:  IM    
Affiliation:
Department of Surgery, Dunedin Hospital, Dunedin, New Zealand. ian.thomson@stonebow.otago.ac.nz
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Anesthesia, Conduction / adverse effects,  statistics & numerical data*
Anesthesia, General / statistics & numerical data
Endarterectomy, Carotid / adverse effects,  statistics & numerical data*
Female
Humans
Length of Stay / statistics & numerical data
Male
Medical Audit
Middle Aged
Nervous System Diseases / etiology
New Zealand
Risk Factors
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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