European Journal of Vascular & Endovascular Surgery
Volume 36, Issue 2 , Pages 145-149 , August 2008

Local versus General Anaesthesia for Carotid Endarterectomy – Improving the Gold Standard ?

  • H.-J. Lutz

      Affiliations

    • Department of Vascular Surgery, University Hospital Giessen, Germany
    • Städtisches Klinikum Dessau, Germany
    • Department of Vascular Medicine, Karolinen Hospital Hüsten, Arnsberg, Germany
    • Corresponding Author InformationCorresponding author. Hans-Joachim Lutz, Department of Vascular Medicine, Karolinen Hospital Hüsten, Stolte Ley 5, D-59759 Arnsberg, Germany. Tel.: +4929329521271; fax: +49293295222271.
  • ,
  • R. Michael

      Affiliations

    • Städtisches Klinikum Dessau, Germany
  • ,
  • B. Gahl

      Affiliations

    • Swiss Cardiovascular Center, University Hospital Bern, Switzerland
  • ,
  • H. Savolainen

      Affiliations

    • Swiss Cardiovascular Center, University Hospital Bern, Switzerland

Received 18 January 2008 ,Accepted 15 March 2008.

References 

  1. North American Symptomatic Carotid Endarterectomy Trial Collaborators . Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N Engl J Med. 1991;325:445–453
  2. Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet. 1998;351:1379–1387
  3. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study . Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  4. Halliday A, Mansfield A, Marro J, et al. MRC Asymptomatic Carotid Surgery Trial (ACST) Collaborative Group Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial. Lancet. 2004;363:1491–1502
  5. Biller J, Feinberg WM, Castaldo JE, Whittemore AD, Harbaugh RE, Dempsey RJ, et al. Guidelines for Carotid Endarterectomy. A statement for Healthcare Professionals from a Special Writing Group of the Stroke Council, American Heart Association. Circulation. 1998;97:501–509Stroke 1998;29:554–562
  6. Yadav JS, Wholey MH, et al., Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy Investigators  Protected carotid-artery stenting versus endarterectomy in high-risk patients (SAPPHIRE). N Engl J Med. 2004;35:1493–1501
  7. Hobson RW, Howard VJ, Roubin GS, for the CREST Investigators . Carotid artery stenting is associated with increased complications in octogarians: 30-day stroke and death rates in the CREST lead-in phase. J Vasc Surg. 2004;40:1106–1111
  8. Featherstone RL, Brown MM, Coward LJ. International carotid stenting study: protocol for a randomised clinical trial comparing carotid stenting with endarterectomy in symptomatic carotid artery stenosis. Cerebrovasc Dis. 2004;18(1):69–74
  9. EVA-3S Investigators . Carotid angioplasty and stenting with and without cerebral protection: clinical alert from the endarterectomy versus angioplasty in patients with symptomatic severe carotid stenosis (EVA-3S) trial. Stroke. 2004;35:e18–e20
  10. Ringleb PA, Allenberg J, Bruckmann H, et al. The SPACE Collaborative Group. 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non inferiority trial. Lancet. 2006;368:1239–1247
  11. Durand H, Masson V, Matte R, Plante JM, d'Amours M. Regional anaesthesia in carotid thrombendarterectomy. Laval Med. 1969;40(3):256–261
  12. Hagmüller GW, Assadian A, Senekowitsch C, Ptakovsky H. Die gefäßchirurgische Therapie von Karotisstenosen. J Kardiol. 2004;11:206–211
  13. Rerkasem K, Bond R, Rothwell PM. Local versus general anaesthesia for carotid endarterectomy. Cochrane Database Syst Rev. 2004;(2):CD000126
  14. GALA Trial (General versus local anaesthesia). Available from: http//www.galatrial.com
  15. Mofidi R, Nimmo AF, Moores C, Murie JA, Chalmers RT. Regional versus general anaesthesia for carotid endarterectomy: impact in change of practice. Surgeon. 2006 Jun;4(3):158–162
  16. Bond R, Rerkasem K, Counsell C, Salinas R, Naylor R, Warlow CP, et al. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Cochrane Database Syst Rev. 2002;(2):CD000190
  17. Watts K, Lin PH, Awad S, McCoy SA, Felkai D, Hhou W, et al. The impact of anaesthetic modality on the outcome of carotid endarterectomy. Am J Surg. 2004 Dec;188(6):741–747
  18. Gabelman C, Gann D, Ashworth C, Carney W. One hundred consecutive carotid reconstructions: local versus general anaesthesia. Am J Surg. 1983;145:477–482
  19. Pandit J, Satya-Krishna R, Gration P. Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications. Br J Anaesth. 2007;99:159–169
  20. Kasprzak PM, Altmeppen J, Angerer M, Mann S, Mackh J, Topel I. General versus local anaesthesia in carotid surgery: a prospective randomized trial. Vasa. 2006 Nov;35(4):232–238
  21. Peitzman A, Webster M, Loubeau J, Grundy BL, Bahnson HT. Carotid endarterectomy under regional (conductive anesthesia). Ann Surg. 1982;196:59–64
  22. Forssell C, Takolander R, Bergqvist D, Johansson A, Persson NH. Local versus general anaesthesia in carotid surgery. A prospective, randomised study. Eur J Vasc Surg. 1989;6:503–509

PII: S1078-5884(08)00178-0

doi: 10.1016/j.ejvs.2008.03.009

European Journal of Vascular & Endovascular Surgery
Volume 36, Issue 2 , Pages 145-149 , August 2008