Anesthesia Management in Case of Carotid Anatomic Variant during Carotid Endarterectomy under General Anesthesia


Carotid endarterectomy is an established treatment in the prevention of transient ischemic attack or stroke. Cerebral embolism, thrombosis or hypo-perfusion will lead to a major risk of perioperative thrombotic events. In this case, we report an interesting anesthesia approach for aortic arch anatomic variant management and monitoring.

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D. Faraoni, B. Mine, G. Apicella and A. Joosten, "Anesthesia Management in Case of Carotid Anatomic Variant during Carotid Endarterectomy under General Anesthesia," Open Journal of Anesthesiology, Vol. 2 No. 2, 2012, pp. 15-17. doi: 10.4236/ojanes.2012.22005.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] North American Symptomatic Carotid Endarterectomy Trial Collaborators, “Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis,” The New England Journal of Medicine, Vol. 325, 1991, pp. 445-453. doi:10.1056/NEJM199108153250701
[2] R. Bond, K. Rerkasem and P. M. Rothwell, “Systematic Review of the Risks of Carotid Endarterectomy in Relation to the Clinical Indication for and Timing of Surgery,” Stroke, Vol. 34, 2003, pp. 2290-2301. doi:10.1161/01.STR.0000087785.01407.CC
[3] K. F. Layton, D. F. Kallmes, H. J. Cloft, E. P. Lindell and V. S. Cox, “Bovine Aortic Arch Variant in Humans: Clarification of a Common Misnomer,” American Journal of Neuroradiology, Vol. 27, 2006, pp. 1541-1542.
[4] G. C. Jakanani and W. Adair, “Frequency of Variations in Aortic Arch Anatomy Depicted on Multidetector CT,” Clinical Radiology, Vol. 65, No. 6, 2010, pp. 481-487. doi:10.1016/j.crad.2010.02.003
[5] N. Attigah, J. Kutter, S. Demirel, M. Hakimi, U. Hinz, J. Motsch and D. Bockler, “Assessment of Patients’ Satisfaction in Carotid Surgery under Local Anaesthesia by Psychometrical Testing—A Prospective Cohort Study,” European Journal of Vascular & Endovascular Surgery, Vol. 41, No. 1, 2011, pp. 76-82. doi:10.1016/j.ejvs.2010.08.020
[6] K. Rerkasem and P. M. Rothwell, “Routine or Selective Carotid Artery Shunting for Carotid Endarterectomy (and Different Methods of Monitoring in Selective Shunting),” Cochrane Database of Systematic Reviews, Vol. 4, 2009.
[7] I. C. van der Schaaf, J. Horn, F. L. Moll and R. G. Ackerstaff, “Transcranial Doppler Monitoring after Carotid Endarterectomy,” Annals of Vascular Surgery, Vol. 19, No. 1, 2005, pp. 19-24. doi:10.1007/s10016-004-0146-y
[8] P. H. Manninen, T. K. Tan and R. M. Sarjeant, “Somatosensory Evoked Potential Monitoring during Carotid Endarterectomy in Patients with a Stroke,” Anesthesia & Analgesia, Vol. 91, No. 1, 2001, pp. 39-44. doi:10.1097/00000539-200107000-00010
[9] T. Mille, M. E. Tachimiri, C. Klersy, G. Ticozzelli, G. Bellinzona, I. Blangetti, S. Pirrelli, M. Lovotti and A. Odero, “Near Infrared Spectroscopy Monitoring during Carotid Endarterectomy: Which Threshold Value Is Critical?” European Journal of Vascular & Endovascular Surgery, Vol. 27, No. 6, 2004, pp. 646-650. doi:10.1016/j.ejvs.2004.02.012
[10] V. Bonhomme, Q. Desiron, T. Lemineur, J. F. Brichant, P. Y. Dewandre and P. Hans, “Bispectral Index Profile during Carotid Cross Clamping,” Journal of Neurosurgical Anesthesiology, Vol. 19, No. 1, 2007, pp. 49-55. doi:10.1097/01.ana.0000211031.49420.c8

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