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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2014
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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. |
format | Online Article Text |
id | pubmed-4533382 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT katanohiroyuki comparisonofinternalshuntsduringcarotidendarterectomyunderroutineshuntingpolicy AT yamadakazuo comparisonofinternalshuntsduringcarotidendarterectomyunderroutineshuntingpolicy |