Central Surgical Association| Volume 82, ISSUE 3, P321-326, September 1977

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Carotid endarterectomy: Is an indwelling shunt necessary?

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      Three hundred and four consecutive endarterectomies were performed with general anesthesia and without a temporary indwelling shunt. Eight patients (2.6%) awoke from anesthesia with a new neurological deficit. Eight additional patients later developed neurological symptoms, suggesting that the absence of a shunt did not contribute to their complication. Of these 16 patients, two (0.6%) died, nine (3.0%) had a temporary neurological deficit, and five (1.6%) had a permanent neurological deficit. A prolonged occlusion time, a stump pressure of less than 50 mm Hg, or the presence of additional carotid lesions did not show a significant statistical relationship to postoperative neurological deficit.
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