Incidence of ischemic lesions by diffusion-weighted imaging after carotid endarterectomy with routine shunt usage.
Temporary intraluminal shunt was used during 72 consecutive carotid endarterectomies (CEAs) in 61 patients (bilateral CEA in 11 patients) during October 2001 and September 2005. The medical records of these patients were retrospectively reviewed. All procedures were performed with routine shunt insertion without monitoring such as electroencephalography. Pre- and postoperative diffusion-weighted magnetic resonance (MR) imaging was used to detect ischemic complications. Postoperative angiography was performed in 70 cases to detect abnormalities such as major stenosis or dissection of the distal end. Symptomatic ischemic complication occurred in one patient at 1 month. Postoperative diffusion-weighted MR imaging detected new hyperintense lesions in three patients including the symptomatic patient. Postoperative angiography confirmed that the distal end was satisfactory in all cases. The incidence of ischemic lesions of embolic origin after CEA with routine shunt usage is acceptably low if the procedure of shunt device insertion and removal is meticulously conducted.
Inoue
Tomohiro
T
Department of Neurosurgery, Showa General Hospital, Kodaira, Tokyo, Japan.
Tsutsumi
Kazuo
K
Maeda
Keiitirou
K
Adachi
Shinobu
S
Tanaka
Shota
S
Yako
Kyoko
K
Saito
Kuniaki
K
Kunii
Naoto
N
D000368:Aged; D000369:Aged, 80 and over; D001807:Blood Vessel Prosthesis / Q000009:adverse effects* / Q000706:statistics & numerical data; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002545:Brain Ischemia / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D002340:Carotid Artery Diseases / Q000473:pathology / Q000601:surgery; D002343:Carotid Artery, Internal / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D016894:Endarterectomy, Carotid / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods / Q000592:standards; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome