carotid disease shunting
02/01/2015
Ref: JVS Jan 2015

The impact of intraoperative shunting on early neurologic outcomes after carotid endarterectomy

Kyla M. Bennett, MD, John E. Scarborough, MD, Mitchell W. Cox, MD, Cynthia K. Shortell, MD
Interesting to see the results: 
 There was no significant difference in the incidence of postoperative stroke/TIA between the two groups of this matched cohort (3.4% in the no-shunt group vs 3.7% in the shunt group; P = .64). 
Analysis of a similarly well matched subgroup of patients with severe stenosis or occlusion of the contralateral carotid artery demonstrated a statistically nonsignificant increase in the incidence of postoperative stroke/TIA with the use of intraoperative shunting (4.9% in the no-shunt group vs 9.8% in the shunt group; P = .08).

My experience in no shunting has been good enough (no postoperative stroke so far)… however, the anaesthetist struggled [seriously] to control the BP where a contralateral stenosis existed .. making me ‘think’ that using a shunt makes life better for the anaesthetist (and patient) in the BP control, no more, no less … 

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