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Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy

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 r...

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Autores principales: KATANO, Hiroyuki, YAMADA, Kazuo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533382/
https://www.ncbi.nlm.nih.gov/pubmed/24305032
http://dx.doi.org/10.2176/nmc.oa2013-0218
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author KATANO, Hiroyuki
YAMADA, Kazuo
author_facet KATANO, Hiroyuki
YAMADA, Kazuo
author_sort KATANO, Hiroyuki
collection PubMed
description 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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spelling pubmed-45333822015-11-05 Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy KATANO, Hiroyuki YAMADA, Kazuo Neurol Med Chir (Tokyo) Original Article 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. The Japan Neurosurgical Society 2014-10 2013-12-05 /pmc/articles/PMC4533382/ /pubmed/24305032 http://dx.doi.org/10.2176/nmc.oa2013-0218 Text en © 2014 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
KATANO, Hiroyuki
YAMADA, Kazuo
Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title_full Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title_fullStr Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title_full_unstemmed Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title_short Comparison of Internal Shunts during Carotid Endarterectomy under Routine Shunting Policy
title_sort comparison of internal shunts during carotid endarterectomy under routine shunting policy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533382/
https://www.ncbi.nlm.nih.gov/pubmed/24305032
http://dx.doi.org/10.2176/nmc.oa2013-0218
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