Complications of carotid artery reconstruction were reviewed in two gr
oups of patients. In group A (213 patients, operation 1978-85) the sur
gical procedure varied according to intraoperatively measured back pre
ssure in the internal carotid artery (ACI), with temporary intralumina
l shunt when the ACI pressure was <50 mmHg, but no shunt when the pres
sure was higher. In group B (339 patients, operation 1986-93), shunt w
as used in all cases. The incidence of complications was higher in gro
up A than in group B (21.6% vs 13%). Temporary or permanent neurologic
deficit occurred in 11.3% of the group A patients and in 5.6% of the
group B patients. Routine use of temporary intraluminal shunt thus res
ulted in fewer complications of carotid artery surgery and allowed the
surgeon to work undisturbed, a prerequisite for a successful outcome.