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Continuing Education in Anaesthesia Critical Care and Pain | Volume 4 Number 2 | 2004
© The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Local anaesthesia for carotid endarterectomy

JR Spargo, MBChB FRCA, Specialist Registrar
Intensive Therapy Unit, Department of Anaesthesia and Intensive Care, Morriston Hospital, Swansea NHS Trust, Swansea

D Thomas, MBChB FRCA, Consultant in Anaesthesia and Intensive Care
Intensive Therapy Unit, Department of Anaesthesia and Intensive Care, Morriston Hospital, Swansea NHS Trust, Swansea, SA6 6NL
Tel: 01792 703468, Fax: 01792 703470, E-mail: dafydd.thomas{at}swansea-tr.wales.nhs.uk (for correspondence)

Carotid endarterectomy is preventative surgery aimed at reducing the rate of stroke in patients at high risk of such an event. Approximately 1% of the British population over 75 years old will die as a result of carotid artery disease each year.

Performing a carotid endarterectomy itself has considerable risk. The rate of perioperative stroke has been reported as 2.2% overall – 1.7% in patients with no prior history of CVA (cardiovascular accident) and 4.2% in those with a previous stroke. Many of these patients have widespread arteriopathic and ischaemic heart disease, chronic obstructive pulmonary disease or diabetes. In addition, they may be smokers and elderly. The co-morbidity associated with carotid disease is therefore considerable. The combined perioperative mortality from myocardial infarction as well as stroke is likely to be less than 2%.


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