[Time and conditions of cerebral ischemic symptoms appearing during carotid endarterectomy under local anesthesia].

In the 1994-1997 238 carotid endarterectomies (CEA) were performed under regional anaesthesia (cervical block) for carotid artery stenosis. In 30 CEA indwelling shunt was necessary. Among 30 patients with shunt 19 (63%) had a stroke before surgery, then 9 (30%) had contralateral internal carotid artery occlusion. Among entire group of 238 patients with CEA 56 (23.5%) had a stroke before surgery and 27 (11.4%) contralateral internal carotid artery occlusion. In our opinion the strongest factor influencing neurological deficiency after clamping trial, is a history of stroke before surgery and in a less degree contralateral internal carotid artery occlusion. The mean time of the neurological deficit during clamping trial was 27 seconds and varied from 5 to 100 sec. and never appeared after 2 minutes of mentioned trial. For that reason we consider 2 minutes clamping trial as sufficient for detection of neurological deficit during CEA under local anaesthesia.