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Cirugía paraguaya

On-line version ISSN 2307-0420

Abstract

FLORES FERREIRA, Liza. CAROTID ENDARTERECTOMY: OUR EXPERIENCE. Rev. Cir. Parag. [online]. 2012, vol.36, n.1, pp.15-20. ISSN 2307-0420.

Introduction: the carotid endarterectomy is to remove the plaque in the carotid arteries, is the treatment of choice of the ateromatosa critique of the carotid bifurcation stenosis that significantly reduces the risk of stroke when compared with natural evolution or the best available medical treatment. The objective of this paper is: determine the demographic characteristics of the patients, evaluate the type of surgical treatment and the anaesthetic technique used and investigate the morbidity of the procedure. Material and methods: This is a descriptive observational study, retrospective cross-sectional, based on medical histories of consecutive patients undergoing carotid endarterectomy in the Central Hospital of the Instituto de Previsión Social - Asuncion Paraguay, during the period from August 2005 to August 2010. Results: 82 Carotids Endarterectomies were performed, 74.39% of patients were males and 25.6% female, ages ranged between 40 and 90 years, being the age strip most affected the distance from 61 years to 80 years, constituting 80% of cases. 54,87% Of patients had a smoking history, associated pathologies include: high blood pressure: 36.5%, diabetes mellitus: 22%, dislipidemia:18%, were also patients with ischemic heart disease, arterial disease of lower limbs, chronic renal failure and aortic aneurysm. All operated patients had color duplex ultrasound, all strictures were critical, over 70%. The procedure was conducted in 60 patients (73,17%) under regional anesthesia and general anesthesia was conducted in 22 patients (14,63%). The average duration of surgery was 103 min (range: 75 to 150 min). Intra operative were not neurological events. In 29 patients (35,36%) was arteriorrafia, in 32 patients (39.02%) was conducted endarterectomy by eversion + replantation, patch of PTFE was used in 20 patients (24,39%) and ligation of the internal carotid by thrombosis was conducted in a patient (1.21%). The morbidity of the procedure was 24,35%. We had a mortality of the 2.43% (2 patients) in these patients was combined between carotid endarterectomy and coronary bypass surgery and the death was due to thrombosis of coronary bypass surgery. Findings: Carotid endarterectomy with regional anesthesia remains the standard method in the management of the stenosis, carotid, mainly due to its low morbidity and mortality perioperative.

Keywords : Endarterectomy Carotids; Regional anaesthesia.

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