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Published on: August 11, 2015
Fixative method of carotid shunt using a Sugita's fenestrated aneurysm clip as a device in carotid endarterectomy
Katsumi Matsumoto1, Satoshi Yamamoto, Kouichirou Turuzono
1Department of Neurosurgery, Iseikai Hospital, Osaka University School of Medicine, Osaka University School of Medicine, Osaka, Japan. byx05641@nifty.ne.jp
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.
Results And Conclusion:
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.
