title: Carotid endarterectomy in an awake patient with contralateral carotid occlusion: influence of selective shunting.
abstract: The objectives of this study were to determine whether the presence of a contralateral carotid occlusion increases risk and whether the perioperative results are influenced by a systematic or selective policy of shunting during carotid endarterectomy (CEA) in an awake patient. In a retrospective study we compared patients with and without contralateral carotid occlusion (group I, n = 198 - group II, n = 1068) who required CEA. In 77 patients of group I, a shunt was systematically adopted (subgroup A); in the other 121 patients (subgroup B) and in all patients of group II a selective shunting policy was adopted. The risk for the patients with contralateral carotid occlusion was not significantly higher than that for patients without occlusion. Results were not influenced by systematic/selective shunting policy, and the incidence of signs of cerebral ischemia was higher in patients with contralateral carotid occlusion.
authors.affiliation: Department of Vascular Surgery, Busto Arsizio Hospital, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Locati
authors.forename: A M
authors.initials: AM
authors.lastname: Socrate
authors.forename: G
authors.initials: G
authors.lastname: Lanza
authors.forename: A
authors.initials: A
authors.lastname: Tori
authors.forename: S
authors.initials: S
authors.lastname: Costantini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies