Anaes Vivas · Vascular anaesthesia
Carotid endarterectomy: GA versus awake and cerebral monitoring — viva
Structured oral examination station for carotid-endarterectomy-anaesthesia.
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Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
Awake CEA: patient stops squeezing right hand 1 minute after clamp; speech garbled.
Opening
State the one-line answer first: GALA equipoise (3,526 patients, 4.8% vs 4.5%) — deficit on clamp means raise MAP, tell the surgeon, shunt selectively.[1][4]
References5ShowHide
- [1]Lewis SC, Warlow CP, Bodenham AR, et al. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. Lancet, 2008.PMID 19041130
- [2]Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation, 1999.PMID 10477528
- [3]Devereaux PJ, Yang H, Yusuf S, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial. Lancet, 2008.PMID 18479744
- [4]Chia MC, Wallace GA, Cheng BT, et al. Identifying a Safe Carotid Stump Pressure Threshold for Selective Shunting During Carotid Endarterectomy. Ann Vasc Surg, 2020.PMID 32554199
- [5]Moulakakis KG, Mylonas SN, Sfyroeras GS, et al. Hyperperfusion syndrome after carotid revascularization. J Vasc Surg, 2009.PMID 19249185