A Technique of Carotid Endarterectomy and Carotid Shunting

With the advent of carotid arterial operations, concerns of interruption of cerebral perfusion and ischemic injury loomed as the major deterrent. The physiologic basis for cerebral protection is to diminish its oxygen requirement by chemical or hypothermic means or to continue its adequate arterial perfusion. The first successful carotid reconstruction resecting an internal carotid stenosis with anastomosis of the patent external carotid to the distal internal carotid artery was performed by Carrea of Argentina in 1951. Preoperatively, ascorbic acid and phenobarbital was given but its rationale was not explained.