title: Proximal shunt dissection: a potential problem in carotid endarterectomy.
abstract: The use of a shunt routinely, selectively, or not at all in performing carotid endarterectomy is a controversial and thus far unsettled dilemma. We have routinely used a shunt because it allows the operation to be done meticulously and without a sense of urgency. However, we recently encountered a case in which proximal subintimal dissection occurred secondary to shunt insertion, which resulted in a postoperative neurologic deficit. We present the case, with a discussion of the probable cause of dissection and its future prevention.
authors.affiliation: Division of Cardiovascular Surgery, Houston Northwest Medical Center, Houston, Texas, USA.
authors.forename: T R
authors.initials: TR
authors.lastname: Calhoun
authors.forename: C M
authors.initials: CM
authors.lastname: Kitten