Routine shunting is a safe and reliable method of cerebral protection during carotid endarterectomy

Annals of Vascular Surgery
Raffaello BellostaAntonio Sarcina

Abstract

The purpose of this report is to describe the perioperative and long-term outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and patching and to show that routine shunting is a safe and reliable method of cerebral protection. Between January 1998 and December 2004, 700 patients attending our Department of Vascular Surgery underwent 786 CEAs performed using a standardized technique. Forty-four patients were excluded from the analysis because they underwent combined CEA and coronary artery bypass grafting, so the analysis is based on the results of 742 CEAs in 656 patients (86 bilateral CEAs). The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting (Javid's shunt) and Dacron patching. The Javid shunts were easily inserted in 738 cases (99.4%) but could not be used in four cases (0.5%) because of the presence of a very small internal carotid artery. The mean ischemic time required to insert the shunt and complete the suture was 4.7 min (+/-1.15), and the mean time to perform the endarterectomy was 34.3 min (+/-6.7). The mean follow-up was 24.4 months (+/-17.3). Overall 30-day mortality was 0.1% (one patient) due to a co...Continue Reading

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Citations

Mar 20, 2012·American Journal of Surgery·Marcus R KretGregory J Landry
Aug 10, 2015·International Journal of Surgery Case Reports·Giulio IlluminatiFrancesco Vietri
Apr 14, 2012·The Korean Journal of Thoracic and Cardiovascular Surgery·Tae Yun KimHyun Kyu Park
Nov 3, 2009·Journal of Vascular Surgery·Nicola TroisiCarlo Pratesi
Nov 5, 2011·Journal of Vascular Surgery·Philip P GoodneyUNKNOWN Vascular Study Group of New England
Mar 1, 2011·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·J C RitterH Rashid
Jan 21, 2015·Journal of Vascular Surgery·Sachinder Singh Hans, Irina Catanescu
Sep 13, 2011·Journal of Vascular Surgery·Ali F AburahmaPatrick A Stone
Aug 20, 2014·Journal of Vascular Surgery·Kyla M BennettCynthia K Shortell
Jul 25, 2009·Vascular and Endovascular Surgery·Kosmas I ParaskevasPeter R F Bell
Apr 2, 2010·Vascular and Endovascular Surgery·Mark L ManwaringMichael C Stoner
Jan 21, 2011·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·D F MüllerE Biemer
Feb 19, 2020·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Damianos G KokkinidisEhrin J Armstrong
Apr 3, 2020·Angiologii︠a︡ i sosudistai︠a︡ khirurgii︠a︡ = Angiology and vascular surgery·A N VachevO V Dmitriev
Jul 27, 2021·The Journal of Cardiovascular Surgery·Francesco SquizzatoMichele Piazza

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