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Risks and Benefits of Shunting in Carotid Endarterectomy
Stroke 23:1583-1587, Halsey,J.H., 1992
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Article Abstract
Severe ischemia occurred in 7.2%of our cases but cleared spontaneously in about half of these.In those with persisting ischemia the rate of severe stroke was very high,while shunting protected against stroke in such cases.If ischemia did not occur,the stroke rate was higher with shunting protected against stroke in such cases.If ischemia did not occur,the stroke rate was higher with shunting,although not so high as in unshunted cases with severe ischemia.Slightly more than one third of the severe strokes were due to postoperative cerebral hemorrhage or carotid thrombosis,unrelated to clamp-induced ischemia or shunting.Carotid endarterectomy complications might be reduced by selectively shunting only for severe persisting ischemia.Monitoring of cerebral ischemia would be essential to selective shunting.
 
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carotid artery occlusion,neck
cerebral ischemia
cerebrovascular accident
cerebrovascular accident,postoperative
doppler,transcranial
endarterectomy,carotid
endarterectomy,carotid-complications of
endarterectomy,carotid-internal shunt with
endarterectomy,carotid-intraoperative monitoring with
intracerebral hemorrhage

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