Background and Goal of Study: Different papers have described great outcomes in patients undergoing ambulatory carotid revascularization reducing costs and increasing patient comfort. In our hospital these patients stay 24h in the intensive care unit. The goal of this study is to determine the incidence of complications after carotid revascularization (stenting /endarterectomy) during the first 24h and to identify risk factors which could help us to select patients for ambulatory procedures.

Materials and Methods: Observational retrospective research. Postsurgical patients undergoing carotid artery revascularization from 2012 to November 2016 were included in the study. 
The data was analysed using a descriptive statistics and the Chi-square test.
P values less than 0.05 were considered statistically significant. All statistical analysis was conducted using SPSS 20.0 for Windows.


Results and Discussion: 160 patients were included in the study ( 128 men,  32 women, mean age 71±9.5 years, range 45-87 years), treated for symptomatic (n=99, 62%) or asymptomatic (n=61 , 38%), endarterectomy (n=40 , 25%), stenting (n=120 , 75%), urgent surgery (n=6,  3,8 %), local anaesthesia ( n= 83, 51,9%), general anaesthesia (n=77, 48,1%).
47 patient ( 29,3%) had a total of 57 complications : 30 (18,8%) episodes of arterial hypertension, 2 (1,2%) episodes of hypotension  , 8 ( 5%) strokes ,7 (4,4%) bleeding, ,7 ( 4,4%) periods of confusion ,1 (0,6%) myocardial infarction, 1 (0,6%) cerebral vasospasm,1 (0,6%) intracerebral hemorrhage. 

Comparing complications whith surgical technique, endarterectomy showed a higher incidence of complications ( 47,5% vs 23,3% stent) P 0,04.

Statistical significance was  also obtained comparing complications between local  (19,27%) vs general anaesthesia  (40%), p 0,04.

It is important to note that complications occurred during the first 6 hours postoperative.

Conclusion(s): This study shows a low incidence of fatal events (stroke, myocardial infarction, intracerebral hemorrhage) in our sample, which can be compared with those published in other studies.
The most common complication was hypertension. However, only two patients with episodes of hypertension developed a fatal outcome (1 stroke, 1 intracerebral hemorrhage).
We consider that our patients undergoing carotid artery stenting may be safely discharged on the same day of surgery. We suggest 6h of observation in the intensive care unit. Nevertheless, patients presenting hypertension or hypotension after the procedure should remain in the hospital due to the potential complications.
We suggest to our colleagues to provide local anaesthesia whenever possible.
On the other hand, we consider our patient sample is not enough to determine whether the outpatient performance of endarterectomy is also a safe practice. In our study it showed twice as complications compared to the stenting.

Carotid revascularization. Can we improve our efficiency?