Carotid endarterectomy with external shunt: a new device and indication for use: technical note.
OBJECTIVE
We designed a new external shunt system and evaluated its indications and efficacy in patients undergoing carotid endarterectomy (CEA).


METHODS
In 8 of 332 CEA procedures, external shunts were placed between the common carotid artery and the internal carotid artery (ICA). This procedure was implemented for one of two indications: 1) a change in electroencephalographic and/or somatosensory evoked potential readings immediately after ICA occlusion, or 2) elongation of the ICA made safe insertion of an internal shunt impossible. In addition, a shunt was placed between the common carotid artery and the external carotid artery to establish collateral circulation from the external carotid artery to the intracranial circulation, which is essential during ICA occlusion.


RESULTS
All external shunts were functional, and electroencephalography and somatosensory evoked potentials demonstrated no significant abnormalities during the CEAs. All patients awoke from surgery without manifestation of new neurological deficits.


CONCLUSIONS
Our new external shunt device proved safe and efficacious in cases that did not permit the placement of an internal shunt.
Uno
M
M
Department of Neurological Surgery, School of Medicine, The University of Tokushima, Japan. neuros@clin.med.tokushima-u.ac.jp
Nishi
K
K
Shinno
K
K
Nagahiro
S
S
D000368:Aged; D017536:Carotid Artery, Common / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000601:surgery*; D002404:Catheterization; D004569:Electroencephalography; D004691:Endarterectomy / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D007440:Intubation; D008297:Male; D008875:Middle Aged; D012449:Safety