Report on initial experience with local anaesthesia for carotid artery endarterectomy

Purpose of the study : This prospective study reports our preliminary results with local anaesthesia (LA) for carotid endarterectomy (CEA). Material and methods : Twenty CEA in nineteen patients were performed using a three-stage local infiltration technique. CEA were performed through a short Duplex-assisted skin incision (median length : 55 mm) using a retro-jugular approach and polyurethane patch closure (median length : 35 mm). Results : There were 13 men and 6 women with a mean age of 71.2 years. The indications of CEA were asymptomatic lesions in 11 cases, stroke in 7 cases and transient ischaemic attack in 2 cases. The median degree of internal carotid artery stenosis was 90%. One patient (5%) required an intraluminal shunt. There were no peri-operative deaths, stroke or conversion to general anaesthesia (GA). The median length of stay was 3 days. Conclusions : LA is a good alternative to GA. It can be used after a feasibility study and a short teaching procedure. In our centre, it is a safe and effective procedure associated with low morbidity, high acceptance by patients and a short hospital stay.