The Pruitt-Inahara shunt maintains mean middle cerebral artery velocities within 10% of preoperative values during carotid endarterectomy

Hayes, Paul D.; Vainas, Tryphon; Hartley, S.; Thompson, M. M.; London, N. J. M.; Bell, P. R. F.; Naylor, A.R.

doi:10.1067/mva.2000.107565

Cited by 26 publications

(16 citation statements)

References 24 publications

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“…The Pruitt-Inahara shunt is unable to maintain an adequate blood flow at the level of the ipsilateral middle cerebral artery in 2% of patients. 11 Sundt et al 1 reported a 0.5% incidence of neurologic complications due to shunt-related microembolization caused by the embolization of atheromatous material from the plaque before performing the CEA or with the passage of embolic material through the shunt, termed snowplow embolism. Loftus et al 6 described a case of distal ICA dissection due to the insertion of a shunt.…”

Section: Discussionmentioning

confidence: 99%

A case of traumatic internal carotid artery aneurysm secondary to carotid shunting

Troisi

Dorigo

Pulli

et al. 2010

Journal of Vascular Surgery

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The use of a carotid shunt is a well-accepted method for the prevention of cerebral ischemia during carotid surgery. Although carotid surgeons are familiar with the risks associated with shunt use, few reports have been published detailing the nature, incidence, or severity of shunt-related complications. We report on a patient with dilatation of the distal cervical internal carotid artery at the site of Pruitt-Inahara (LeMaitre Vascular, Inc. Burlington, Mass) shunt balloon inflation. To our knowledge, this complication of shunting during carotid endarterectomy has not been previously described.

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Section: Discussionmentioning

confidence: 99%

A case of traumatic internal carotid artery aneurysm secondary to carotid shunting

Troisi

Dorigo

Pulli

et al. 2010

Journal of Vascular Surgery

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“…The Pruitt Inahara Shunt is a device that allows for the maintenance of cerebral blood flow during carotid surgery. This shunt is placed into the vessel and uses balloons to keep the artery patent as the plaque is being removed [9]. Since the PA in our case was located distal to the vascular patch site or the endarterectomized area of the carotid artery, we concluded that the balloon portion of the shunt likely caused blunt trauma to the artery.…”

Section: Discussionmentioning

confidence: 93%

Successful Obliteration of a Pseudoaneurysm from Post-CEA Repair Secondary to a Pruitt-Inahara Shunt Using a Stent Graft

Dahya

Chalasani

2013

Case Reports in Vascular Medicine

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Pseudoaneurysms of the carotid artery are very uncommon complications following carotid endarterectomy. Pseudoaneurysms are usually caused by any kind of blunt injury or trauma during carotid artery surgery. CEA has become an increasingly more common vascular surgery performed in the United States. The standard of treatment for a carotid PA has been open surgical repair with excision of the defect and then a graft reconstruction of the artery. Advancements in endovascular intervention have helped to make it a more popular choice in treatment because of the positive results and less invasive approach. This case report describes the successful obliteration of a large post-CEA PA using a stent graft. The PA was likely secondary to the use of a Pruitt-lnahara Shunt because it was found to be distal to the endarterectomized area of the carotid artery which means that the defect was likely caused by the balloon portion of the shunt. This case demonstrates the feasibility of using endovascular interventional techniques to treat a PA using a stent graft.

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“…1). [18][19][20][21] The clamping time for the CCA for inserting the PI shunt is never more than 2 minutes. As irreversible hypoxic-ischemic brain injury begins after 5 minutes, this maneuver is considered safe.…”

Section: Discussionmentioning

confidence: 99%

The pruitt‐inahara carotid shunt as an assisting tool to anastomose the arterial free flap pedicle to the internal carotid artery in the vessel‐depleted neck

et al. 2011

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Microvascular free tissue transfer in head and neck reconstruction requires suitable recipient vessels which are frequently compromised by prior surgery or radiotherapy to the neck. This article details a new technique of arterial free flap pedicle anastomosis to the internal carotid artery in a vessel-depleted neck. A 63-year-old female was referred because of recurrence of squamous cell carcinoma of the tongue, which involved the left-sided tongue base and pharynx with circumferential involvement of the homolateral external carotid artery. This artery and its branches were excluded as potential recipients. To close the defect after tumor excision, a free vertical rectus abdominis muscle arterial flap pedicle was anastomosed to the homolateral internal carotid artery with the help of a Pruitt-Inahara outlying carotid shunt. The venous anastomosis was performed to the internal jugular vein. The VRAM flap survived without complications. This procedure is to be considered an alternative rescue technique for salvage reconstruction in vessel depleted necks.

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The Pruitt-Inahara shunt maintains mean middle cerebral artery velocities within 10% of preoperative values during carotid endarterectomy

Abstract: The Pruitt-Inahara shunt is able to maintain adequate middle cerebral artery velocity in 98% of patients undergoing carotid endarterectomy. Alterations in blood pressure can significantly affect flow through the shunt.

Cited by 26 publications

References 24 publications

A case of traumatic internal carotid artery aneurysm secondary to carotid shunting

A case of traumatic internal carotid artery aneurysm secondary to carotid shunting

Successful Obliteration of a Pseudoaneurysm from Post-CEA Repair Secondary to a Pruitt-Inahara Shunt Using a Stent Graft

The pruitt‐inahara carotid shunt as an assisting tool to anastomose the arterial free flap pedicle to the internal carotid artery in the vessel‐depleted neck

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