{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T23:36:14Z","timestamp":1777332974470,"version":"3.51.4"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Das perioperative Ergebnis 30 Tage nach Karotisendarteriektomie (CEA) in\n\t\t\t\tLokalan\u00e4sthesie (LA) vs. Allgemeinan\u00e4sthesie (AA) bei Patienten mit Karotisstenose\n\t\t\t\tsollte Propensity-gematcht untersucht werden.<\/jats:p>\n                  <jats:p>Erfasst wurden in einer retrospektiven Multicenterstudie 1966 Patienten mit\n\t\t\t\tsymptomatischer (37,9%) und asymptomatischer (62,1%) Karotisstenose aus 8 deutschen\n\t\t\t\tgef\u00e4\u00dfchirurgischen Kliniken. Die Eingriffe wurden in 918 F\u00e4llen (46,7%) in LA und in\n\t\t\t\t1048 F\u00e4llen (53,3%) in AA vorgenommen. Nach Durchf\u00fchrung des Propensity-Matchings\n\t\t\t\tverblieben jeweils 836 Patienten pro Gruppe f\u00fcr LA und AA.<\/jats:p>\n                  <jats:p>Nicht adjustiert fanden sich keine signifikanten Unterschiede in den\n\t\t\t\tpostoperativen Komplikationen (LA vs. AA: Tod 0,7% bei LA und AA; Apoplex 1,3% vs.\n\t\t\t\t1,7%; Herzinfarkt 0,6% vs. 0,3%; Major Adverse Cardiovascular Events (MACE) 2,9% vs.\n\t\t\t\t2,3%). In der multivariaten Analyse zeigte sich ebenfalls kein signifikanter\n\t\t\t\tUnterschied im Risiko f\u00fcr schwere Komplikationen (Schlaganfall, Myokardinfarkt, Tod,\n\t\t\t\tReoperation) bei LA (OR: 1,17 [95%-KI: 0,65\u20132,10]; p\u00a0=\u00a00,596) im Vergleich zu AA.\n\t\t\t\tAuch f\u00fcr leichte Komplikationen (H\u00e4matom, Hirnnervenverletzung, Restenose) war der\n\t\t\t\tUnterschied statistisch nicht signifikant (OR: 1,30 [95%-KI: 0,70\u20132,42]; p\u00a0=\u00a00,401).\n\t\t\t\tAuch die postoperative Aufenthaltsdauer (Mittelwert: 4,7\u00a0\u00b1\u00a03,0 Tage) war nicht\n\t\t\t\tunterschiedlich. In der gematchten Gesamtkohorte ergab sich ein erh\u00f6htes Risiko f\u00fcr\n\t\t\t\tschwere Komplikationen bei Alter &gt;\u00a080 Jahre (OR: 1,65; [95%-KI: 1,05\u20132,59];\n\t\t\t\tp\u00a0=\u00a00,030). Bei den leichten Komplikationen war m\u00e4nnliches Geschlecht mit einem\n\t\t\t\tsignifikant niedrigeren Risiko assoziiert (OR: 0,69 [95%-KI: 0,49\u20130,96]; p\u00a0=\u00a00,027),\n\t\t\t\tebenfalls symptomatische Stenose (OR: 0,59 [95%-KI: 0,42\u20130,83]; p\u00a0=\u00a00,003). Eine\n\t\t\t\tl\u00e4ngere Eingriffszeit war hingegen mit einem erh\u00f6hten Risiko verbunden (pro 10\u00a0min:\n\t\t\t\tOR: 1,08 [95%-KI: 1,03\u20131,14]; p\u00a0=\u00a00,004). Die Art der An\u00e4sthesie (Lokal- vs.\n\t\t\t\tAllgemeinan\u00e4sthesie) war in keinem der beiden Modelle signifikant unterschiedlich\n\t\t\t\tmit dem Auftreten von Komplikationen assoziiert.<\/jats:p>\n                  <jats:p>Die Studie unterstreicht die Empfehlung der Leitlinien, das An\u00e4sthesieverfahren\n\t\t\t\tbei CEA der Erfahrung des Chirurgen und An\u00e4sthesisten sowie der Pr\u00e4ferenz des\n\t\t\t\tPatienten zu \u00fcberlassen.<\/jats:p>","DOI":"10.1055\/a-2845-6778","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:46:34Z","timestamp":1777329994000},"source":"Crossref","is-referenced-by-count":0,"title":["Lokalan\u00e4sthesie vs. Allgemeinan\u00e4sthesie bei Karotiseingriffen: eine Propensity-Score-gematchte Multicenterstudie"],"prefix":"10.1055","author":[{"given":"Radu","family":"Tabac","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Viszeral-, Thorax- und Gef\u00e4\u00dfchirurgie, Universit\u00e4tsklinikum Carl Gustav Carus, Dresden, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shervin","family":"Taheripour","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Gef\u00e4\u00dfmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corneliu","family":"Lisii","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00df- und Endovaskul\u00e4re Chirurgie, Marienhospital Osnabr\u00fcck, Osnabr\u00fcck, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mareike","family":"Ruckert","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00df- und Endovaskul\u00e4re Chirurgie, Klinikum Saarbr\u00fccken gGmbH, Saarbr\u00fccken, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlotta","family":"Linder","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00dfchirurgie, St\u00e4dtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor","family":"Cebotari","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00df- und Endovaskul\u00e4re Chirurgie, St. Josefs-Hospital Cloppenburg, Cloppenburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kleinschmidt","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00df- und Endovaskul\u00e4re Chirurgie, Asklepios Klinikum Harburg, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Nentwig","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Abteilung f\u00fcr Gef\u00e4\u00dfmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Gef\u00e4\u00df- und Endovaskul\u00e4re Chirurgie, Universit\u00e4t Heidelberg, Heidelberg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Debus","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Abteilung f\u00fcr Gef\u00e4\u00dfmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reinhart T.","family":"Grundmann","sequence":"additional","affiliation":[{"name":"Universit\u00e4res Herz- und Gef\u00e4\u00dfzentrum Hamburg, Abteilung f\u00fcr Gef\u00e4\u00dfmedizin, Universit\u00e4tsklinikum Hamburg-Eppendorf, Hamburg, 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