Hemodynamic performance of carotid artery shunts

Aufiero, Thomas X.; Thiele, Brian L.; Rossi, John A.; Miller, Cynthia A.; Neumyer, Marsha M.

doi:10.1016/0002-9610(89)90354-1

Cited by 10 publications

(4 citation statements)

References 8 publications

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“…This determination can often be aided by the use of continuous-wave Doppler. [21][22][23][24][25][26][27][28][29] In cases where there is injury to more than one of the small distal arteries (e.g., both ulnar and radial arteries) resulting in an absence of Doppler signal beyond the injury, use of a vascular shunt is recommended. 33 Those who have extensive experience with placing shunts frequently state that in the setting of penetrating vascular injury, the two ends of the severed vessel must be exposed for ligation anyway.…”

Section: Venous Shuntingmentioning

confidence: 99%

“…27 Aufiero et al also recommend the use of tapered shunts when smaller diameter shunts (<12 Fr) are required. 28 Several physical characteristics must be weighed when selecting the type of shunt to use, and a list of features of commonly used devices is provided in Table 17-4. In-line shunts are shorter and useful when operative space is limited and when the gap in or injury to the vessel is short.…”

Section: Shunt Materialsmentioning

confidence: 99%

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Surgical Damage Control and Temporary Vascular Shunts

Scott¹,

Rasmussen²

2016

Rich's Vascular Trauma

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Section: Venous Shuntingmentioning

confidence: 99%

Section: Shunt Materialsmentioning

confidence: 99%

Surgical Damage Control and Temporary Vascular Shunts

Scott¹,

Rasmussen²

2016

Rich's Vascular Trauma

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“…Shunt tubes are generally divided into two categories: two-way and three-way types. The former includes Sundt, 2) Javid, 3) and Argyle 4) shunts, and the latter Pruitt-Inahara, 5) Brener, 6) and Furui 7) shunts. Most surgeons tend to have a favorite shunt and prefer not to use a different type, especially with selective shunting protocol providing fewer opportunities of handling shunts than routine shunting.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy

Katano

Yamada

2014

Neurol. Med. Chir.(Tokyo)

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We compared patients who underwent carotid endarterectomy (CEA) using two-way and three-way internal shunts and discussed which shunt was more appropriate and effective for surgeons. Eighty-two patients (mean 69.5 ± 6.1 years old, mean degrees of stenosis 79.6 ± 10.4%) who had undergone CEA by our routine shunting policy were examined concerning the difference of Sundt and Pruitt-Inahara (P-I) shunts in clinical use. Carotid clamping time for the P-I shunt was over 2 minutes longer than that by Sundt in either split or conventional continuous arteriotomy (p < 0.001). The proportions of cases with multiple trials of either arteriotomy or insertion of a shunt tube, cases detected more than one high-intensity spot on diffusion-weighted images of magnetic resonance imaging after CEA, and cases detected postoperative intimal flaps detected by multi-detector CT angiography showed no significant differences between the two shunt groups. The two-way Sundt shunt was quicker than the three-way P-I shunt in placement with no remarkable problems. Split arteriotomy was not useful in shortening the placement time for either Sundt or P-I shunt tubes, compared with continuous arteriotomy. A simple two-way shunt with easy handling like the Sundt shunt would be also appropriate to choose in selective shunting under the unfamiliarity of treating shunts.

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“…10,11 The smaller shunts have been criticized on the basis of their smaller luminal diameter and, because flow is inversely proportional to the fourth power of the radius, their greater resistance to blood flow. 8,12 A study of 163 patients found that the Javid shunt failed to maintain preoperative middle cerebral artery velocities (MCAVs) in 41%; the corresponding figure for the Pruitt-Inahara device was 66%. 8 The present study was performed to examine MCAV changes in 548 patients who were routinely shunted with the Pruitt-Inahara shunt, examining not only the deviation from preoperative flow rates but also the relation between use of the shunt and markers of inadequate perfusion.…”

mentioning

confidence: 99%