Carotid endarterectomy in an awake patient with contralateral carotid occlusion: Influence of selective shunting

The objectives of this study were to determine whether the presence of a co ntralateral carotid occlusion increases risk and whether the perioperative results are influenced by a systematic or selective policy of shunting duri ng carotid endarterectomy (CEA) in an awake patient. In a retrospective stu dy we compared patients with and without contralateral carotid occlusion (g roup I, n = 198 - group II, n = 1068) who required CEA. In 77 patients of g roup I, a shunt was systematically adopted (subgroup A); in the other 121 p atients (subgroup B) and in all patients of group II a selective shunting p olicy was adopted. The risk for the patients with contralateral carotid occ lusion was not significantly higher than that for patients without occlusio n. Results were not influenced by systematic/selective shunting policy, and the incidence of signs of cerebral ischemia was higher in patients with co ntralateral carotid occlusion. DOI: 10.1007/s100169910081.