The impact of anesthetic modality on the outcome of carotid endarterectomy.

Ken Watts, Peter H. Lin, Ruth L. Bush, Samir Awad, Sally A. McCoy, Deborah Felkai, Wei Zhou, Liz Nguyen, Marlon A Guerrero, Salwa A. Shenaq, Alan B. Lumsden

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

BACKGROUND: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with high-grade carotid artery stenosis. This study evaluates the clinical outcome of CEA performed under local anesthesia (LA) versus general anesthesia (GA). METHODS: Clinical variables and treatment outcomes were analyzed in 548 CEAs performed under either LA or GA during a 30-month period. Factors associated with morbidity were also analyzed. RESULTS: A total of 263 CEAs under LA and 285 CEA under GA were analyzed. The LA group was associated with a lower incidence of shunt placement, operative time, and perioperative hemodynamic instability compared to the GA group. No differences in neurologic complications or mortality were found between the 2 groups. Hyperlipidemia was a risk factor for postoperative morbidity in both the LA and GA groups, while age greater than 75 years was associated with increased overall morbidity in the GA group but not the LA group. CONCLUSIONS: This study demonstrates that increased age is associated with increased morbidity in CEA under GA, while hyperlipidemia is associated with increased morbidity in CEA regardless of the anesthetic choice.

Original languageEnglish (US)
Pages (from-to)741-747
Number of pages7
JournalAmerican Journal of Surgery
Volume188
Issue number6
StatePublished - Dec 2004
Externally publishedYes

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Carotid Endarterectomy
General Anesthesia
Local Anesthesia
Anesthetics
Morbidity
Hyperlipidemias
Carotid Stenosis
Operative Time
Nervous System
Age Groups
Hemodynamics
Stroke
Mortality
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Watts, K., Lin, P. H., Bush, R. L., Awad, S., McCoy, S. A., Felkai, D., ... Lumsden, A. B. (2004). The impact of anesthetic modality on the outcome of carotid endarterectomy. American Journal of Surgery, 188(6), 741-747.

The impact of anesthetic modality on the outcome of carotid endarterectomy. / Watts, Ken; Lin, Peter H.; Bush, Ruth L.; Awad, Samir; McCoy, Sally A.; Felkai, Deborah; Zhou, Wei; Nguyen, Liz; Guerrero, Marlon A; Shenaq, Salwa A.; Lumsden, Alan B.

In: American Journal of Surgery, Vol. 188, No. 6, 12.2004, p. 741-747.

Research output: Contribution to journalArticle

Watts, K, Lin, PH, Bush, RL, Awad, S, McCoy, SA, Felkai, D, Zhou, W, Nguyen, L, Guerrero, MA, Shenaq, SA & Lumsden, AB 2004, 'The impact of anesthetic modality on the outcome of carotid endarterectomy.', American Journal of Surgery, vol. 188, no. 6, pp. 741-747.
Watts K, Lin PH, Bush RL, Awad S, McCoy SA, Felkai D et al. The impact of anesthetic modality on the outcome of carotid endarterectomy. American Journal of Surgery. 2004 Dec;188(6):741-747.
Watts, Ken ; Lin, Peter H. ; Bush, Ruth L. ; Awad, Samir ; McCoy, Sally A. ; Felkai, Deborah ; Zhou, Wei ; Nguyen, Liz ; Guerrero, Marlon A ; Shenaq, Salwa A. ; Lumsden, Alan B. / The impact of anesthetic modality on the outcome of carotid endarterectomy. In: American Journal of Surgery. 2004 ; Vol. 188, No. 6. pp. 741-747.
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AU - Awad, Samir

AU - McCoy, Sally A.

AU - Felkai, Deborah

AU - Zhou, Wei

AU - Nguyen, Liz

AU - Guerrero, Marlon A

AU - Shenaq, Salwa A.

AU - Lumsden, Alan B.

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N2 - BACKGROUND: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with high-grade carotid artery stenosis. This study evaluates the clinical outcome of CEA performed under local anesthesia (LA) versus general anesthesia (GA). METHODS: Clinical variables and treatment outcomes were analyzed in 548 CEAs performed under either LA or GA during a 30-month period. Factors associated with morbidity were also analyzed. RESULTS: A total of 263 CEAs under LA and 285 CEA under GA were analyzed. The LA group was associated with a lower incidence of shunt placement, operative time, and perioperative hemodynamic instability compared to the GA group. No differences in neurologic complications or mortality were found between the 2 groups. Hyperlipidemia was a risk factor for postoperative morbidity in both the LA and GA groups, while age greater than 75 years was associated with increased overall morbidity in the GA group but not the LA group. CONCLUSIONS: This study demonstrates that increased age is associated with increased morbidity in CEA under GA, while hyperlipidemia is associated with increased morbidity in CEA regardless of the anesthetic choice.

AB - BACKGROUND: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with high-grade carotid artery stenosis. This study evaluates the clinical outcome of CEA performed under local anesthesia (LA) versus general anesthesia (GA). METHODS: Clinical variables and treatment outcomes were analyzed in 548 CEAs performed under either LA or GA during a 30-month period. Factors associated with morbidity were also analyzed. RESULTS: A total of 263 CEAs under LA and 285 CEA under GA were analyzed. The LA group was associated with a lower incidence of shunt placement, operative time, and perioperative hemodynamic instability compared to the GA group. No differences in neurologic complications or mortality were found between the 2 groups. Hyperlipidemia was a risk factor for postoperative morbidity in both the LA and GA groups, while age greater than 75 years was associated with increased overall morbidity in the GA group but not the LA group. CONCLUSIONS: This study demonstrates that increased age is associated with increased morbidity in CEA under GA, while hyperlipidemia is associated with increased morbidity in CEA regardless of the anesthetic choice.

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