Outcome of LA Versus GA for Staged CEA Prior To CABG

Study Overview
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Brief Summary
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A retrospective analysis of all patients that underwent carotid endarterectomy (CEA) for stenotic disease - diagnosed at pre-operative investigation - prior to CABG as staged operation within 6- months. The rate of postoperative stroke and complications was compared between CEA performed under Local anaesthetic (LA) to those performed under General anaesthetic (GA).

Detailed Description
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The primary outcome was the rate of postoperative stroke in patients that had staged CEA prior to CABG. This was defined as CEA within a period of 4 weeks prior to CABG. We retrospectively looked at those patients that fulfilled the inclusion criteria and had CEA performed either under LA (Group A) or under GA (Group B). We measured the 30 days' postoperative stroke rate as the main outcome. We also looked at the rate of intraoperative stroke. Additionally, we assessed the rate for developing nerve injuries and/or hematoma postoperatively. Finally, we examined the risk for developing postoperative stroke in patients with bilateral significant carotid artery disease that underwent surgery in one side.

Official Title
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Outcome of Local Versus General Anesthetic for Staged Carotid Endarterectomy Prior To CABG, Cohort Study

Conditions
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Carotid Artery Diseases, Coronary Artery Disease, Stroke

Intervention / Treatment
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* Procedure: Carotid endarterectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: - All patients that had carotid endarterectomy performed in staged fashion within 6 months before a CABG operation. Exclusion Criteria: Patients diagnosed with symptomatic carotid disease
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Carotid Endarterectomy under Local Anaesthetic Pre-CABG<br>Patients that underwent carotid endarterectomy under local anaesthetic prior to coronary artery bypass operations in staged fashion within 6 months. | Procedure: Carotid endarterectomy<br>* Carotid endarterectomy prior to CABG operations either under Local Anaesthetic or under General Anaesthetic.<br>|
| Carotid Endarterectomy under General Anaesthetic Pre-CABG<br>Patients that underwent carotid endarterectomy under general anaesthetic prior to coronary artery bypass operations in staged fashion within 6 months. | Procedure: Carotid endarterectomy<br>* Carotid endarterectomy prior to CABG operations either under Local Anaesthetic or under General Anaesthetic.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Stroke | a transient ischaemic attack (TIA), or a disabling stroke within 30 days of the carotid endarterectomy procedure. | 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major bleeding | Major haematoma was defined as a significant bleeding that required the patient to go back to theatre for a secondary procedure. | 30 days | 
| Minor bleeding | A minor hematoma was defined as bleeding that resulted in bruising and neck swelling without causing significant concerns to require a secondary procedur | 30 days | 
| Nerve injuries | Either neuropraxia that resolved with time or permanent injuries that resulted in disability. | 30 days |