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Our experience with carotid endarterectomy without patch and shunt
V Andrikopoulos1, I Antoniou, G Papacharalambous
1Department of Vascular Surgery, KAT Hospital, Athens, Greece.
Summary
Endarterectomy without a shunt is a safe and effective surgical option for carotid stenosis. This method demonstrated low rates of permanent and temporary neurological deficits in the study group.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiovascular Research
Background:
- Atherosclerotic carotid stenosis poses a significant risk for stroke.
- Carotid endarterectomy is a common procedure to prevent ischemic events.
- The use of shunts, patches, and monitoring during carotid endarterectomy is debated.
Purpose of the Study:
- To evaluate the efficacy and safety of carotid endarterectomy performed without a shunt, patch, or other monitoring methods.
- To assess neurological outcomes in patients undergoing this simplified surgical approach.
Main Methods:
- A retrospective analysis of 98 patients with unilateral atherosclerotic carotid stenosis.
- Patients underwent endarterectomy without shunt, patch, EEG, or stump pressure monitoring.
- Patients were stratified into three groups based on preoperative clinical symptoms.
Main Results:
- The study reported an overall neurologic morbidity of 2% permanent and 4% temporary deficits.
- No intraoperative monitoring or shunting was employed in any of the procedures.
- The procedure was considered simple and safe in the absence of concomitant hemodynamically significant lesions.
Conclusions:
- Carotid endarterectomy without a shunt is a viable and safe surgical technique.
- Neurological complications observed were likely attributed to embolization rather than intraoperative ischemia.
- This simplified approach may be suitable for select patient populations with carotid stenosis.