Carotid endarterectomy using regional anesthesia: technique and considerations

• Published in: Frontiers in surgery Vol. 11; p. 1421624
• Main Authors: Padmanaban, Varun, Caldwell, Catherine, Milne, Indigo, Hazard, Sprague W, Harbaugh, Robert E, Church, Ephraim W
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 06.06.2024
• Subjects: awake carotid endarterectomy (CEA); carotid disease; carotid endarterectomy; regional anesthesia (RA); Surgery; surgical technique
• ISSN: 2296-875X; 2296-875X
• DOI: 10.3389/fsurg.2024.1421624

Carotid endarterectomy (CEA) is one of the most effective operations in minimizing stroke risk in both symptomatic and asymptomatic patients with carotid stenosis in the United States. Awake CEA with regional anesthesia may decrease both perioperative complications and length of hospital stay. Techniques of performing awake CEA is not often described in published literature.BackgroundCarotid endarterectomy (CEA) is one of the most effective operations in minimizing stroke risk in both symptomatic and asymptomatic patients with carotid stenosis in the United States. Awake CEA with regional anesthesia may decrease both perioperative complications and length of hospital stay. Techniques of performing awake CEA is not often described in published literature.To describe our experience with CEA using regional anesthesia with a focus on patient selection, anatomic variations, and surgical technique including cervical regional block. We particularly focus on nuances of the awake approach.ObjectiveTo describe our experience with CEA using regional anesthesia with a focus on patient selection, anatomic variations, and surgical technique including cervical regional block. We particularly focus on nuances of the awake approach.CEA using regional anesthesia is described in detail.MethodsCEA using regional anesthesia is described in detail.Successful use of regional anesthesia during CEA without complication.ResultsSuccessful use of regional anesthesia during CEA without complication.Regional anesthesia for CEA is an advantageous approach for cervical plaque removal in appropriate patients. Thoughtful patient selection, as well as understanding of anatomy and its variants, is required. Potential advantages and disadvantages are discussed.ConclusionRegional anesthesia for CEA is an advantageous approach for cervical plaque removal in appropriate patients. Thoughtful patient selection, as well as understanding of anatomy and its variants, is required. Potential advantages and disadvantages are discussed.