Evidence overview for shunting, patching, type of endarterectomy and anesthesia during carotid surgery

Carotid endarterectomy has been shown to reduce the risk for stroke in patients with symptomatic or selected asymptomatic severe internal carotid artery stenosis. Although the basic aims of surgery are always the same, the exact techniques used to achieve them vary between surgeons. This paper summarizes the current evidence based optimal technical management of patients with an indication for carotid surgery, focusing on shunt use, patching, eversion versus longitudinal endarterectomy, and type of anesthesia applied. For each subtopic discuss, the text is accompanied by a table summarizing the key points.