Carotid endarterectomy under locoregional anaesthetic
The carotid arteries or arteries in your neck provide the blood supply to the brain. These blood vessels, like the coronary arteries around the heart, can become narrowed due to formation of atherosclerotic plaques or calcium layers. Removing these atherosclerotic plaques from the carotid arteries can be done under a general or local (locoregional) anaesthetic.
At UZ Brussel half of all carotid endarterectomy procedures are carried out under local anaesthetic. The Vascular Surgery department works closely with the Stroke Unit in the Neurology department on these operations.
Advantages of locoregional anaesthesia
- The advantage of locoregional anaesthesia is that the patient’s nerve and brain activity can be assessed during the operation. This is done by getting the patient to count aloud during certain parts of the operation, such as when the artery is clamped, or asking them to squeeze the nurse’s hand.
- Complications such as an acute cerebrovascular accident can then be detected more quickly and dealt with immediately.
- This technique is considered to be more reliable than measuring brain activity during general anaesthesia and it also means that there is no need for extra equipment.
- In addition, research has shown that locoregional anaesthesia leads to a fall in the use of intraluminal shunts and that there is a lower risk of hypertension occurring during the operation.
- Postoperatively most studies show no difference in postoperative complications between local and general anaesthetics, although some studies do report fewer complications when patients are treated with a local anaesthetic.