CAROTID-ARTERY RECONSTRUCTION AND ROUTINE USE OF INTRALUMINAL SHUNT

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.