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Syrovatskiy A.A.

Sokolov North-Western District Scientific and Clinical Center

Saiganov S.A.

Mechnikov North-Western State Medical University

Lebedinskii K.M.

North-Western State Medical University n.a. Mechnikov, Federal Research;
Clinical Center of Intensive Care Medicine and Rehabilitology

Anesthesia technique choice motives for carotid endarterectomy

Authors:

Syrovatskiy A.A., Saiganov S.A., Lebedinskii K.M.

More about the authors

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To cite this article:

Syrovatskiy AA, Saiganov SA, Lebedinskii KM. Anesthesia technique choice motives for carotid endarterectomy. Russian Journal of Anesthesiology and Reanimatology. 2022;(2):73‑79. (In Russ.)
https://doi.org/10.17116/anaesthesiology202202173

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References:

  1. Rerkasem A, Orrapin S, Howard DP, Rerkasem K. Carotid endarterectomy for symptomatic carotid stenosis. Cochrane Database of Systematic Reviews. 2020;9(9):CD001081. https://doi.org/10.1002/14651858.cd001081.pub3
  2. Halliday A, Harrison M, Hayter E. Ten-Year Stroke Prevention after Successful Carotid Endarterectomy for Asymptomatic Stenosis (ACST-1): A Multicentre Randomised Trial. Journal of Vascular Surgery. 2011;53(1):246.  https://doi.org/10.1016/j.jvs.2010.11.037
  3. North American Symptomatic Carotid Endarterectomy Trial Collaborators; Barnett HJM, Taylor DW, Haynes RB, Sackett DL, Peerless SJ, Ferguson GG, Fox AJ, Rankin RN, Hachinski VC, Wiebers DO, Eliasziw M. Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis. New England Journal of Medicine. 1991;325(7):445-453.  https://doi.org/10.1056/nejm199108153250701
  4. Endarterectomy for asymptomatic carotid artery stenosis. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. JAMA. 1995;273(18):1421-1428. https://doi.org/10.1001/jama.273.18.1421
  5. Pokrovskiy AV, Golovyuk AL. The state of vascular surgery in the Russian Federation in 2018. Angiologiya i sosudistaya khirurgiya. 2019;25(2 Suppl): 3-40. (In Russ.).
  6. Vaniyapong T, Chongruksut W, Rerkasem K. Local versus general anaesthesia for carotid endarterectomy. Cochrane Database of Systematic Reviews. 2013;12:CD000126. https://doi.org/10.1002/14651858.cd000126.pub4
  7. Stevanovic K, Sabljak V, Kukic B, Toskovic A, Markovic D, Zivaljevic V. A Brief History of Carotid Artery Surgery and Anesthesia. Journal of Anesthesia History. 2016;2(4):147-150.  https://doi.org/10.1016/j.janh.2016.09.005
  8. Simonov OV, Tyurin IN, Pryamikov AD, Mironkov AB. The Choice of the Type of Anesthesia for Carotid Endarterectomy (Review). Obshchaya reanimatologiya. 2018;14(6):95-113. (In Russ.). https://doi.org/10.15360/1813-9779-2018-6-95-113
  9. Shmigelsky AV, Lubnin AYu. Anesthesia during carotid endaterectomy. Anesteziologiya i Reanimatologiya. 2008;2:47-57. (In Russ.).
  10. Cedergreen P, Swiatek F, Nielsen HB. Local anaesthesia for carotid endarterectomy. European Journal of Anaesthesiology. 2016;33(4):236-237.  https://doi.org/10.1097/eja.0000000000000370
  11. Unic-Stojanovic D, Jovic M. Local anaesthesia for carotid endarterectomy. European Journal of Anaesthesiology. 2016;33(4):238-240.  https://doi.org/10.1097/eja.0000000000000377
  12. Unic-Stojanovic D, Babic S, Neskovic V. General versus Regional Anesthesia for Carotid Endarterectomy. Journal of Cardiothoracic and Vascular Anesthesia. 2013;27(6):1379-1383. https://doi.org/10.1053/j.jvca.2012.09.021
  13. Hajibandeh S, Hajibandeh S, Antoniou S, Torella F, Antoniou G. Meta-analysis and trial sequential analysis of local vs. general anaesthesia for carotid endarterectomy. Anaesthesia. 2018;73(10):1280-1289. https://doi.org/10.1111/anae.14320
  14. GALA Trial Collaborative Group, Lewis SC, Warlow CP, Bodenham AR, Colam B, Rothwell PM, Torgerson D, Dellagrammaticas D, Horrocks M, Liapis C, Banning AP, Gough M, Gough MJ. General anaesthesia versus local anaesthesia for carotid surgery (GALA): A multicentre, randomised controlled trial. The Lancet. 2008;372(9656):2132-2142. https://doi.org/10.1016/s0140-6736(08)61699-2
  15. Harky A, Chan JSK, Kot TKM, Sanli D, Rahimli R, Belamaric Z, Ng M, Kwan IYY, Bithas C, Makar R, Chandrasekar R, Dimitri S. General anaesthesia versus local anaesthesia in carotid endarterectomy: A systematic review and meta-analysis. Journal of Cardiothoracic and Vascular Anesthesia. 2019. https://doi.org/10.1053/j.jvca.2019.03.029
  16. Marsman MS, Wetterslev J, Keus F, van Aalst D, van Rooij FG, Heyligers JMM, Moll FL, Jahrome AK, Vriens PWHE, Koning GG. Plexus anesthesia versus general anesthesia for carotid endarterectomy: A systematic review with meta-analyses. Annals of Medicine and Surgery. 2021;65:102327. https://doi.org/10.1016/j.amsu.2021.102327
  17. Mracek J, Kletecka J, Mork J, Stepanek D, Dostal J, Mrackova J, Priban V. Indications for General versus Local Anesthesia during Carotid Endarterectomy. Journal of Neurological Surgery. Part A, Central European Neurosurgery. 2019;80(4):250-254.  https://doi.org/10.1055/s-0039-1678601
  18. Akhmedov AD, Usachev DYu, Lukshin VA, Shmigelsky AV, Belyaev AYu, Sosnin AD. Carotid endarterectomy in patients with high surgical risk. Voprosy neirokhirurgii im. N.N. Burdenko. 2013;77(4):36-41. (In Russ.).
  19. Santamaria G, Britti RD, Tescione M, Moschella A, Bellinvia C. Comparison between local and general anaesthesia for carotid endarterectomy. A retrospective analysis. Minerva Anestesiologica. 2004;70(11):771-778. 
  20. Quigley TM, Ryan W, Morgan S. Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia. The American Journal of Surgery. 2000;179(5):382-385.  https://doi.org/10.1016/s0002-9610(00)00371-8
  21. Kim J, Huh U, Song S, Sung S, Hong J, Cho A. Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia. The Korean Journal of Thoracic and Cardiovascular Surgery. 2019;52(6):392-399.  https://doi.org/10.5090/kjtcs.2019.52.6.392
  22. Kalko Y, Kafali E, Aydin U, Kafa U, Kosker T, Basaran M, Ugurlucan M, Nargileci E, Yasar T. Surgery of the Carotid Artery: Local Anaesthesia Versus General Anaesthesia. Acta Chirurgica Belgica. 2007;107(1):53-57.  https://doi.org/10.1080/00015458.2007.11680011
  23. Siu A, Patel J, Prentice HA, Cappuzzo JM, Hashemi H, Mukherjee D. A Cost-Effective Analysis Comparing Regional to General Anesthesia for Carotid Endarterectomy. Annals of Vascular Surgery. 2015;61(6):101.  https://doi.org/10.1016/j.jvs.2015.04.198
  24. Gomes M, Soares MO, Dumville JC, Lewis SC, Torgerson DJ, Bodenham AR, Gough MJ, Warlow CP; GALA Collaborative Group. Cost-effectiveness analysis of general anaesthesia versus local anaesthesia for carotid surgery (GALA Trial). British Journal of Surgery. 2010;97(8):1218-1225. https://doi.org/10.1002/bjs.7110
  25. Schechter M, Shortell C, Scarborough J. Regional versus general anesthesia for carotid endarterectomy: The American College of Surgeons National Surgical Quality Improvement Program perspective. Surgery. 2012;152(3):309-314.  https://doi.org/10.1016/j.surg.2012.05.008
  26. Vetrugno L, Di Luca E, Drigo D, Fregonese V, Gonano N, Giordano F. Wake-Up Test Decrease Shunts Insertion During Carotid Endarterectomy Under General Anesthesia. Vascular and Endovascular Surgery. 2010;44(3):174-178.  https://doi.org/10.1177/1538574409359428
  27. Migliara B, Trentin M, Idone D, Mirandola M, Griso A, Lino M. Neurocognitive Changes After Eversion Carotid Endarterectomy Under Local Anesthesia. Annals of Vascular Surgery. 2013;27(6):727-735.  https://doi.org/10.1016/j.avsg.2012.06.029
  28. Mracek J, Holeckova I, Chytra I, Mork J, Stepanek D, Vesela P. The impact of general versus local anesthesia on early subclinical cognitive function following carotid endarterectomy evaluated using P3 event-related potentials. Acta Neurochirurgica. 2012;154(3):433-438.  https://doi.org/10.1007/s00701-011-1270-4
  29. Meitzner MC, Skurnowicz JA, Mitchell A. A literature review on anesthetic practice for carotid endarterectomy surgery based on cost, hemodynamic stability, and neurologic status. AANA Journal. 2007;75(3):193-197. 
  30. Bevilacqua S, Romagnoli S, Ciappi F, Lazzeri C, Gelsomino S, Pratesi C, Gensini GF. Anesthesia for Carotid Endarterectomy: The Third Option. Patient Cooperation during General Anesthesia. Anesthesia and Analgesia. 2009;108(6):1929-1936. https://doi.org/10.1213/ane.0b013e31819f6f7b
  31. De Santis F, Margot Chaves Brait C, Pattaro C, Cesareo V, Di Cintio V. A Prospective Nonrandomized Study on Carotid Surgery Performed under General Anesthesia without Intraoperative Cerebral Monitoring. Journal of Stroke and Cerebrovascular Diseases. 2016;25(1):136-143.  https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.006
  32. Kim T, Choi J, Kim K, Kim M, Shin B, Park H. Routine Shunting is Safe and Reliable for Cerebral Perfusion during Carotid Endarterectomy in Symptomatic Carotid Stenosis. The Korean Journal of Thoracic and Cardiovascular Surgery. 2012;45(2):95-100.  https://doi.org/10.5090/kjtcs.2012.45.2.95
  33. Aburahma A, Mousa A, Stone P. Shunting during carotid endarterectomy. Journal of Vascular Surgery. 2011;54(5):1502-1510. https://doi.org/10.1016/j.jvs.2011.06.020
  34. Aburahma AF, Stone PA, Hass SM, Dean LS, Habib J, Keiffer T, Emmett M. Prospective randomized trial of routine versus selective shunting in carotid endarterectomy based on stump pressure. Journal of Vascular Surgery. 2010;51(5):1133-1138. https://doi.org/10.1016/j.jvs.2009.12.046
  35. Shmigelsky AV, Usachev DYu, Lukshin VA, Ogurtsova AA, Lubnin AYu, Sazonova OB, Shakhnovich VA. Multimodal neuromonitoring in the early diagnosis of cerebral ischemia during carotid artery reconstruction. Anesteziologiya i Reanimatologiya. 2008;2:16-21. (In Russ.).
  36. Bourke V, Bourke B, Beiles C. Operative Factors Associated with the Development of New Brain Lesions During Awake Carotid Endarterectomy. European Journal of Vascular and Endovascular Surgery. 2016;51(2):167-173.  https://doi.org/10.1016/j.ejvs.2015.08.022
  37. Wolf O, Heider P, Heinz M, Poppert H, Sander D, Greil O, Weiss W, Hanke M, Eckstein HH. Microembolic Signals Detected by Transcranial Doppler Sonography during Carotid Endarterectomy and Correlation with Serial Diffusion-Weighted Imaging. Stroke. 2004;35(11):373-375.  https://doi.org/10.1161/01.str.0000143184.69343.ec
  38. Lobo M, Mourão J, Afonso G. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal. Brazilian Journal of Anesthesiology. 2015;65(4):249-254.  https://doi.org/10.1016/j.bjane.2014.03.011
  39. Jamil M, Usman R, Ghaffar S. Advantages of Selective Use of Intraluminal Shunt in Carotid Endarterectomy: a Study of 122 Cases. Annals of Vascular Diseases. 2016;9(4):285-288.  https://doi.org/10.3400/avd.oa.16-00036
  40. Dellaretti M, de Vasconcelos L, Dourado J, de Souza R, Fontoura R, de Sousa A. Locoregional Anesthesia for Carotid Endarterectomy: Identification of Patients with Intolerance to Cross-Clamping. World Neurosurgery. 2016;87:61-64.  https://doi.org/10.1016/j.wneu.2015.11.097
  41. Rocha-Neves J, Pereira-Macedo J, Dias-Neto M, Andrade J, Mansilha A. Benefit of selective shunt use during carotid endarterectomy under regional anesthesia. Vascular. 2020;28(5):505-512.  https://doi.org/10.1177/1708538120922098
  42. Mendonça CT, Fortunato JA Jr, Carvalho CA, Weingartner J, Filho OR, Rezende FF, Bertinato LP. Carotid endarterectomy in the awake patient: safety, tolerability and results. Revista Brasileira de Cirurgia Cardiovascular. 2014;29(4):574-580.  https://doi.org/10.5935/1678-9741.20140053
  43. Bowyer M, Zierold D, Loftus J, Egan J, Inglis K, Halow K. Carotid Endarterectomy: A Comparison of Regional versus General Anesthesia in 500 Operations. Annals of Vascular Surgery. 2000;14(2):145-151.  https://doi.org/10.1007/s100169910026
  44. Chongruksut W, Vaniyapong T, Rerkasem K. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting). Cochrane Database of Systematic Reviews. 2014;2014(6):CD000190. https://doi.org/10.1002/14651858.cd000190.pub3
  45. Leopardi M, Musilli A, Piccolo E, Marrelli A, Martinazzo C, Maggipinto A. Multimodal Neurophysiological Monitoring Reduces Shunt Incidence During Carotid Endarterectomy. Journal of Vascular Surgery. 2019;70(6):2101. https://doi.org/10.1016/j.jvs.2019.09.007
  46. Domenick Sridharan N, Thirumala P, Chaer R, Balzer J, Long B, Crammond D, Makaroun M, Avgerinos E. Predictors of cross-clamp-induced intraoperative monitoring changes during carotid endarterectomy using both electroencephalography and somatosensory evoked potentials. Journal of Vascular Surgery. 2018;67(1):191-198.  https://doi.org/10.1016/j.jvs.2017.04.064
  47. Heyer EJ, Gold MI, Kirby EW, Zurica J, Mitchell E, Halazun HJ, Teverbaugh L, Sciacca RR, Solomon RA, Quest DO, Maldonado TS, Riles TS, Connolly ES Jr. A Study of Cognitive Dysfunction in Patients Having Carotid Endarterectomy Performed with Regional Anesthesia. Anesthesia and Analgesia. 2008;107(2):636-642.  https://doi.org/10.1213/ane.0b013e3181770d84
  48. Watanabe J, Ogata T, Hamada O, Nonaka M, Abe H, Higashi T, Shiota E, Inoue T. Improvement of Cognitive Function after Carotid Endarterectomy — A New Strategy for the Evaluation of Cognitive Function. Journal of Stroke and Cerebrovascular Diseases. 2014;23(6):1332-1336. https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.11.004
  49. Paraskevas K, Lazaridis C, Andrews C, Veith F, Giannoukas A. Comparison of Cognitive Function After Carotid Artery Stenting Versus Carotid Endarterectomy. Journal of Vascular Surgery. 2014;59(3):874.  https://doi.org/10.1016/j.jvs.2014.01.016
  50. Neymark MI, Shmelyov VV, Titova ZA, Khaustova SA, Shadymov BA. Comparative evaluation of anesthesia methods for reconstructive carotid surgery. Vestnik anesteziologii i reanimatologii. 2020;17(5):15-24. (In Russ.). https://doi.org/10.21292/2078-5658-2020-17-5-15-24
  51. Jovic M, Unic-Stojanovic D, Isenovic E, Manfredi R, Cekic O, Ilijevski N, Babic S, Radak D. Anesthetics and Cerebral Protection in Patients Undergoing Carotid Endarterectomy. Journal of Cardiothoracic and Vascular Anesthesia. 2015;29(1):178-184.  https://doi.org/10.1053/j.jvca.2014.05.019
  52. Zhao H, Sapolsky R, Steinberg G. Interrupting Reperfusion as a Stroke Therapy: Ischemic Postconditioning Reduces Infarct Size after Focal Ischemia in Rats. Journal of Cerebral Blood Flow and Metabolism. 2006;26(9): 1114-1121. https://doi.org/10.1038/sj.jcbfm.9600348
  53. Kitano H, Kirsch J, Hurn P, Murphy S. Inhalational Anesthetics as Neuroprotectants or Chemical Preconditioning Agents in Ischemic Brain. Journal of Cerebral Blood Flow and Metabolism. 2006;27(6):1108-1128. https://doi.org/10.1038/sj.jcbfm.9600410
  54. Michenfelder J, Sundt T, Fode N, Sharbrough F. Isoflurane When Compared to Enflurane and Halothane Decreases the Frequency of Cerebral Ischemia During Carotid Endarterectomy. Anesthesiology. 1987;67(3):336-340.  https://doi.org/10.1097/00000542-198709000-00010
  55. Kaisti KK, Långsjö JW, Aalto S, Oikonen V, Sipilä H, Teräs M, Hinkka S, Metsähonkala L, Scheinin H. Effects of Sevoflurane, Propofol, and Adjunct Nitrous Oxide on Regional Cerebral Blood Flow, Oxygen Consumption, and Blood Volume in Humans. Anesthesiology. 2003;99(3):603-613.  https://doi.org/10.1097/00000542-200309000-00015
  56. Cai J, Hu Y, Li W, Li L, Li S, Zhang M, Li Q. The neuroprotective effect of propofol against brain ischemia mediated by the glutamatergic signaling pathway in rats. Neurochemical Research. 2011;36(10):1724-1731. https://doi.org/10.1007/s11064-011-0487-1
  57. Takagi H, Umemoto T. Remote Ischemic Preconditioning for Cardiovascular Surgery: An Updated Meta-Analysis of Randomized Trials. Vascular and Endovascular Surgery. 2011;45(6):511-513.  https://doi.org/10.1177/1538574410379654
  58. Healy DA, Boyle E, McCartan D, Bourke M, Medani M, Ferguson J, Yagoub H, Bashar K, O’Donnell M, Newell J, Canning C, McMonagle M, Dowdall J, Cross S, O’Daly S, Manning B, Fulton G, Kavanagh EG, Burke P, Grace PA, Moloney MC, Walsh SR; Preconditioning Shields against Vascular Events in Surgery (Preconditioning SAVES) Trial Group. A MultiCenter Pilot Randomized Controlled Trial of Remote Ischemic Preconditioning in Major Vascular Surgery. Vascular and Endovascular Surgery. 2015;49(8):220-227.  https://doi.org/10.1177/1538574415614404
  • Simegn GD, Bayable SD, Fetene MB. Prevention and management of perioperative hypothermia in adult elective surgical patients: A systematic review. Ann Med Surg (Lond). 2021;72:103059. https://doi.org/10.10167j.amsu.2021.103059
  • Harvey CJ. Evidence-Based Strategies for Maternal Stabilization and Rescue in Obstetric Hemorrhage. AACNAdv Crit Care. 2018;29(3):284-294.  https://doi.org/10.4037/aacnacc2018966
  • Kander T, Schott U. Effect of hypothermia on haemostasis and bleeding risk: A narrative review. J Int Med Res. 2019;47(8):3559-3568. https://doi.org/10.1177/0300060519861469
  • Pacagnella RC, Borovac-Pinheiro A. Assessing and managing hypovolemic shock in puerperal women. Best Pract Res Clin Obstet Gynaecol. 2019;61: 89-105.  https://doi.org/10.1016/j.bpobgyn.2019.05.012
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