Anesthesia for carotid endarterectomy

Abstract

Carotid endarterectomy (CEA) is a preventative procedure performed in the presence of well-defined indications. Although the impact of the type of anesthetic method on outcomes has been extensively studied, it remains unresolved whether regional or general anesthesia is superior in CEA. The use of a carotid shunt is based on neurological monitoring during clamping. Although various techniques have been used to monitor cerebral perfusion under general anesthesia and detect cerebral ischemia during carotid artery cross-clamping, none are completely reliable. Drastic hemodynamic changes may be observed during both the intraoperative and postoperative periods. It is essential to maintain adequate systemic and cerebral hemodynamics during the perioperative period.