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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 2004 December;163(6):239-42
Short clamping time and thiopental sodium protection in carotid endarterectomy. Perioperative results
Fuseri M. 1, Nicoletti A. 1, Biglioli P. 2
1 Vascular and Endovascular Surgery Unit, Monza Polyclinic, Monza, Italy;
2 Cardiovascular Department, IRCCS Monzino Foundation, University of Milan, Milan, Italy
Aim. The purpose of this study was to evaluate the efficacy of a minimally invasive carotid endarterectomy (CEA) standard technique associated with thiopental sodium (Penthotal) cerebral protection as an alternative to routine shunting.
Methods. A retrospective consecutive series of 100 carotid endarterectomies was reviewed. All CEAs were performed for symptomatic or asymptomatic carotid stenosis >70% under general anesthesia and thiopental sodium cerebral protection with electroencephalographic control. A standard CEA with a longitudinal arteriotomy of the common carotid artery and a minimal arteriotomy of the internal carotid artery was performed in all cases. No intraluminal shunt was used in favour of thiopental cerebral protection. Clinical examination and a color duplex scan were performed at 1 month after surgery.
Results. In this series we had no death, 1 major stroke and 2 transient ischemic neurological deficits. All deficits were ipsilateral and related to technical complications rather than failed cerebral protection. Non-neurological complications included 2 symptom-free recurrent stenosis >50% at 1 month and 2 cranial nerve injuries. No early carotid occlusion, wound hematoma or myocardial infarction were recorded.
Conclusion. In this series CEA associated with a short clamping time and thiopental sodium cerebral protection has been effective in terms of low ischemic stroke rate, patency rate and speed of surgery. Further follow-up is necessary to evaluate recurrent stenosis rate.