Results of routine shunting and patch closure during carotid endarterectomy

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• 作者：Marcus R. Kret ; M.D. ; Brandon Young ; B.S. ; Gregory L. Moneta ; M.D. ; Timothy K. Liem ; M.D. ; Erica L. Mitchell ; M.D. ; Amir F. Azarbal ; M.D. ; Gregory J. Landry ; M.D. ; ^{landryg@ohsu.edu}
• 关键词：Carotid endarterectomy ; Shunt ; Patch angioplasty ; Stroke
• 刊名：The American Journal of Surgery
• 出版年：2012
• 期刊代码：9_00029610
• 类别：med
• 出版时间：May, 2012
• 卷：203
• 期：5
• 页码：613-617
• 文件大小：149 K

摘要

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.