title: Fixative method of carotid shunt using a Sugita's fenestrated aneurysm clip as a device in carotid endarterectomy technical note.
abstract: BACKGROUND
  Difficulty for distal exposure of the ICA is sometimes encountered during CEA. A carotid shunt is used to maintain sufficient cerebral blood flow during CEA but requires fixative materials, such as a string or a metallic ring, which often restrict the operative field, especially that of the distal ICA.
  
  
  METHODS
  Here, we describe a novel technique for carotid shunt fixation using a unique fixative device in CEA. In the method presented here, the carotid shunt is fixed with an inflated balloon and a conventional vascular tourniquet proximally, but distal fixation is achieved using a Sugita's fenestrated clip that catches the mid portion of the carotid shunt and surrounding tissue.
  
  
  CONCLUSIONS
  The device prevents the distal carotid shunt slipping out of the distal ICA. The present method allows mobilization of the shunt position during CEA and facilitates far-distal exposure of the ICA.
authors.affiliation: Department of Neurosurgery, Iseikai Hospital, Osaka University School of Medicine, Osaka University School of Medicine, Osaka, Japan. byx05641@nifty.ne.jp
authors.forename: Katsumi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Turuzono
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Tomio
authors.initials: T
authors.lastname: Ohta
authors.forename: Toru
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Toshiki
authors.initials: T
authors.lastname: Yoshimine
mesh_terms: D020520:Brain Infarction / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D002343:Carotid Artery, Internal / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002560:Cerebrovascular Circulation; D016894:Endarterectomy, Carotid / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013525:Surgical Instruments; D014111:Tourniquets; D016896:Treatment Outcome