Abstract
One of the major concerns of carotid endarterecomy (CEA) is to protect the brain from ischemic insult caused by cross-clamping of the internal carotid artery (ICA). The most effective way is to maintain carotid flow during surgical procedures. We have introduced a newly devised shunt system, T-shaped silicone shunt tubes and clamping devices. The tube has enough pliability and length to be used in a looped or U-shaped mode and forms a T-shape with a side arm available for monitoring blood pressure in the shunt system. Clamping devices, modified Sugita ring clips for the distal side and bulldog clamps for the proximal side, make it possible to hold the tube by a simple maneuver and to minimize the intimal damage. Using this shunt system 170 CEAs were performed, and mortality and morbidity were 0% and 2.4%, respectively. We have demonstrated CEA can be safely and easily performed with a routine application of our shunt system.
