Results of routine shunting and patch closure during carotid endarterectomy

Marcus R. Kret, Brandon Young, Gregory L. Moneta, Timothy K. Liem, Erica L. Mitchell, Amir F. Azarbal, Gregory J. Landry

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

BACKGROUND: The role of shunting and patching during carotid endarterectomy remains controversial. METHODS: This is a retrospective case series evaluating consecutive patients undergoing carotid endarterectomy with routine shunting and patching. The primary endpoints were perioperative stroke, arterial injury, and lesion recurrence by duplex. RESULTS: Of the 220 operations performed, 43% were for symptomatic disease. Successful shunt placement occurred in 98%, with no shunt-related injuries. There was 1 minor perioperative stroke and no major strokes. At a mean follow-up of 24 months (median = 12 months), there was 1 restenosis potentially related to shunt placement. The incidence of asymptomatic >50% stenosis in the patched segment was 8%. CONCLUSIONS: A combined policy of routine shunting and patching simplifies intraoperative decision making with results that rival or exceed those of trials in which their use was not standardized. Shunts need not be avoided because of concern of arterial injury.

Original languageEnglish (US)
Pages (from-to)613-617
Number of pages5
JournalAmerican journal of surgery
Volume203
Issue number5
DOIs
StatePublished - May 1 2012

Keywords

  • Carotid endarterectomy
  • Patch angioplasty
  • Shunt
  • Stroke

ASJC Scopus subject areas

  • Surgery

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