Carotid endarterectomy with regional anesthesia: An audit of 71 cases

AMAÇ: Karotis endarterektomide amaç, herhangi bir komplikasyon olmadan aterosklerotik plağın dikkatlice çıkarılarak patent arter karotisin yeniden tamiridir. Bölgesel anestezi nörolojik monitorizasyona olanak sağlaması nedeniyle tercih edilen yöntemlerden birisidir. Bu çalışmanın amacı, bölgesel anestezi ile karotis endarterektomi uygulanan olgularımızın retrospektif olarak gözden geçirilerek klinik sonuçlarımızın incelenmesidir.YÖNTEM ve GEREÇ: 2000 – 2006 tarihleri arasında 71 olgu bölgesel anestezi ile karotis endarterektomi operasyonuna alınmıştır. Hastaların bilgileri prospektif olarak kaydedilmiştir. Tüm olgular nörovasküler ekip tarafından ameliyat öncesinde ve sonrasında takip edilmiştir. Bütün prospektif data retrospektif olarak analiz edilmiştir.BULGULAR: Olgularımızın 23'ü kadın, 48'i erkekti ve ortalama yaşları 62 (37-79) bulundu. 67 hasta semptomatik (%94,4), 4 hasta asemptomatikdi (%5.6). Altı (%8,45) hasta karotis kapatılmasını tolere etmedi. Mortalite %1,4 morbidite %1,4 olarak belirlendi. Hastanede kalma süreleri ortalama 2,07 (1-10) gündü.SONUÇ: Uyanık hastada bölgesel anestezi ile karotis endarterektomisi güvenli bir yöntemdir. Ameliyat sırasında oluşabilecek serebral iskeminin monitorizasyonu, seçici şant uygulanabilmesi, yoğun bakım ihtiyacının olmaması ve hastanede kalış sürelerinin kısa olması da bu tekniğe ayrı avantajlar sağlamaktadır.

Anahtar Kelime: Anestezi, blok İleriye dönük çalışma Yatış süresi Ölüm oranı Endarterektomi, karotis Yaş dağılımı Hastalık oranı Cinsiyet dağılımı Geriyedönük çalışma

Konular: Cerrahi

Bölgesel anestezi ile karotis endarterektomisi: 71 vakanın dökümü

Öz:

AIM: The aim of carotid endarterectomy (CEA) is the successful removal of the atherosclerotic plaque and meticulous anatomical and physiological reconstruction of the carotid artery without any perioperative complications. Endarterectomy can also be carried out with regional anesthesia, which allows monitoring of the neurological status. This study reviews patients who underwent CEA with regional anesthesia.MATERIAL and METHODS: A total of 71 consecutive patients were planned to undergo carotid endarterectomy under regional anesthesia between 2000 and 2006. All of these patients, assessed by our neurovascular team, were recruited prospectively and the data was analyzed retrospectively.RESULTS: The study group consisted of 23 women and 48 men with a mean age of 62 (range 37-79). 67 patients (94,4%) had symptomatic, and 4 (5,6%) had asymptomatic (5.6%) carotid stenosis. Six patients (8.45%) were intolerant to carotid clamping (8,45%). The stroke morbidity rate was 1.4% and the mortality rate was 1.4%. The mean hospitalization time was 2.07 (range 1-10) days.CONCLUSION: Carotid endarterectomy performed under regional anesthesia can be a safe method which may lead to better neurological outcome. This method offers several advantages including monitorization of the cerebral ischemia during surgery, usage of selective shunting, decreased need for intensive care and shorter hospitalization time.

Anahtar Kelime: Endarterectomy, Carotid Age Distribution Morbidity Sex Distribution Retrospective Studies Anesthesia, Conduction Prospective Studies Length of Stay Mortality

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KARASU A, KUŞÇU Y, BAKAÇ G, OFLUOĞLU E, AKKOYUN N, YALÇINER B, DAYAN C, BAHAR S, KIRIS T, ÜYE M, TOPLAMOĞLU H (2009). Carotid endarterectomy with regional anesthesia: An audit of 71 cases. , 21 - 28.
Chicago	KARASU Aykut,KUŞÇU Yandım Demet,BAKAÇ Göksel,OFLUOĞLU Ender,AKKOYUN Nesrin,YALÇINER Betül,DAYAN Cengiz,BAHAR Sara,KIRIS TALAT,ÜYE Muammer,TOPLAMOĞLU Halil Carotid endarterectomy with regional anesthesia: An audit of 71 cases. (2009): 21 - 28.
MLA	KARASU Aykut,KUŞÇU Yandım Demet,BAKAÇ Göksel,OFLUOĞLU Ender,AKKOYUN Nesrin,YALÇINER Betül,DAYAN Cengiz,BAHAR Sara,KIRIS TALAT,ÜYE Muammer,TOPLAMOĞLU Halil Carotid endarterectomy with regional anesthesia: An audit of 71 cases. , 2009, ss.21 - 28.
AMA	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H Carotid endarterectomy with regional anesthesia: An audit of 71 cases. . 2009; 21 - 28.
Vancouver	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H Carotid endarterectomy with regional anesthesia: An audit of 71 cases. . 2009; 21 - 28.
IEEE	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H "Carotid endarterectomy with regional anesthesia: An audit of 71 cases." , ss.21 - 28, 2009.
ISNAD	KARASU, Aykut vd. "Carotid endarterectomy with regional anesthesia: An audit of 71 cases". (2009), 21-28.

APA	KARASU A, KUŞÇU Y, BAKAÇ G, OFLUOĞLU E, AKKOYUN N, YALÇINER B, DAYAN C, BAHAR S, KIRIS T, ÜYE M, TOPLAMOĞLU H (2009). Carotid endarterectomy with regional anesthesia: An audit of 71 cases. Turkish Neurosurgery, 19(1), 21 - 28.
Chicago	KARASU Aykut,KUŞÇU Yandım Demet,BAKAÇ Göksel,OFLUOĞLU Ender,AKKOYUN Nesrin,YALÇINER Betül,DAYAN Cengiz,BAHAR Sara,KIRIS TALAT,ÜYE Muammer,TOPLAMOĞLU Halil Carotid endarterectomy with regional anesthesia: An audit of 71 cases. Turkish Neurosurgery 19, no.1 (2009): 21 - 28.
MLA	KARASU Aykut,KUŞÇU Yandım Demet,BAKAÇ Göksel,OFLUOĞLU Ender,AKKOYUN Nesrin,YALÇINER Betül,DAYAN Cengiz,BAHAR Sara,KIRIS TALAT,ÜYE Muammer,TOPLAMOĞLU Halil Carotid endarterectomy with regional anesthesia: An audit of 71 cases. Turkish Neurosurgery, vol.19, no.1, 2009, ss.21 - 28.
AMA	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H Carotid endarterectomy with regional anesthesia: An audit of 71 cases. Turkish Neurosurgery. 2009; 19(1): 21 - 28.
Vancouver	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H Carotid endarterectomy with regional anesthesia: An audit of 71 cases. Turkish Neurosurgery. 2009; 19(1): 21 - 28.
IEEE	KARASU A,KUŞÇU Y,BAKAÇ G,OFLUOĞLU E,AKKOYUN N,YALÇINER B,DAYAN C,BAHAR S,KIRIS T,ÜYE M,TOPLAMOĞLU H "Carotid endarterectomy with regional anesthesia: An audit of 71 cases." Turkish Neurosurgery, 19, ss.21 - 28, 2009.
ISNAD	KARASU, Aykut vd. "Carotid endarterectomy with regional anesthesia: An audit of 71 cases". Turkish Neurosurgery 19/1 (2009), 21-28.