Routine Shunting Is a Safe and Reliable Method of Cerebral Protection during Carotid Endarterectomy

Gefäßanschluss an die A. carotis communis

“…Die mittlere Ischämiezeit, die zur Einbringung des Javid-Shunts erforderlich ist, beträgt etwa 4-5 min [6]. Die Indikation zur Verwendung des Javid-Shunts wurde initial aufgrund des erschwerten neurologischen Monitorings bei Allgemeinnarkose in Abhängigkeit vom Sonographiebefund großzügig gestellt.…”

Carotid Endarterectomy with Routine Shunt for Patients with Contralateral Carotid Occlusion

“…19) Routine shunting has been used for cerebral protection during CEA for a long time. 8) Its advantages include the avoidance of intraoperative neurologic monitoring and ease of shunt insertion. 8) A report by Goodney et al 20) showed that surgeons using routine shunting during CEA in patients with CCO achieved a lower incidence of perioperative complications compared with surgeons who used selective shunting during CEA.…”

“…8) Its advantages include the avoidance of intraoperative neurologic monitoring and ease of shunt insertion. 8) A report by Goodney et al 20) showed that surgeons using routine shunting during CEA in patients with CCO achieved a lower incidence of perioperative complications compared with surgeons who used selective shunting during CEA. However, another study showed that shunts are not necessary and are associated with air embolization, distal flap creation, displacement of embolic material, etc.…”

“…7) The increased stroke rates of patients with CCO may be due to their impaired cerebral functional reserves, making the brain more fragile. 7) A routine intraoperative shunt could provide reliable cerebral protection 8) and may benefit the carotid stenosis patients with CCO.…”

Temporary intraluminal shunting in reconstructive surgery of brachiocephalic arteries

“…При низкой толерантности головного мозга некото-рые авторы [5,11] рекомендуют применять временное ВПШ на стороне операции, другие отказываются от него, полагаясь на скорость выполнения процедуры. Постанов-ка ВПШ, по мнению ряда авторов, имеет потенциальную опасность -расслоение дистального отдела ВСА, мате-риальная эмболия фрагментом бляшки.…”