Awake Carotid Endarterectomy in Patients Undergoing Cardiac Surgery: Our 6 Years of Experience

Objective: Optimal surgical approach for patients with hemodynamically significant carotid and cardiac disease remains controversial.Methods: Total of 370 randomized patients who underwent 412 carotid endarterectomies (42 cases were bilateral) and cardiac surgery between 2009 and 2014 were enrolled in the study.All patient data, including demographic details, risk factors, immediate perioperative events, 30-day and long-term outcome, were prospectively recorded and then analyzed statistically as mean and SD.Results: Of the patients, 29.4% (n=108) were female and 70.6% (n=262) were male.Mean age was 64 years (range: 42-86 years).In all, 37.03% (n=137) of the patients were defined as symptomatic.Asymptomatic severe carotid artery stenosis (≥70%) was diagnosed in 62.98% (n=233) of the patients.Mean observation time in intensive care unit following surgery was 2.84 (±1.20) hours and total hospital stay was 3.72 (±1.64) days.Restenosis was diagnosed in 7 (1.69%) of the patients during follow-up.Rate of cardiac events and stroke in postoperative early term were 2.94% and 0.72%, respectively.Conclusion: Awake carotid endarterectomy is safe and reliable procedure.Patient consciousness can be optimally evaluated during operation with regional anesthesia, thereby allowing for precise determination of need for shunt and avoiding unnecessary use.