Abstract
Risks of shunt placement during carotid endarterectomy (CEA) include carotid dissection and embolization through the shunt. These rare complications appear to be familiar to neurosurgeons but are infrequently described in the literature. In this report, we describe 2 patients who suffered postoperative carotid stenosis far distal to the operative site. A 68-year-old male with a symptomatic moderate stenosis of the left internal carotid artery (ICA) developed a carotid dissection at the site of shunt placement after CEA. He was successfully treated with carotid artery stenting (CAS). A 77-year-old male with an asymptomatic severe stenosis of the left ICA suffered transient stenosis of the distal ICA due to spasm caused by mechanical stress during shunt placement. As a result of conservative management with clinical and radiologic follow-up, complete resolution of stenosis was observed the day after surgery. In both cases, no apparent neurological deficits were observed soon after CEA. Postoperative angiography can help detect shunt-related complications early.
