Carotid endarterectomy (CEA) is an effective treatment for patients with cervical internal carotid artery stenosis; this has been demonstrated in multiple large clinical trials. We perform CEA for adaptive cases with a unified surgical procedure. In order to avoid ischemic complications associated with carotid artery clamping during surgery, we use an indwelling shunt for almost all cases (routine shunting). In this article, we evaluate the effectiveness and safety of routine shunting retrospectively, focusing on surgical techniques and results at our facility. In 234 patients, 255 CEAs were performed at our facility from April 2012 to March 2018. Among the 255 CEAs, diffusion-weighted imaging (DWI) positive lesions were found in 14 cases (5.5%). However, no symptomatic cerebral infarction was observed. As a result of examination of the complications, 4 cases (1.6%) had symptomatic complications at 30 days after surgery, of which 1 case (0.4%) died. We concluded that CEA with routine shunting yields good surgical results through a unified surgical procedure and careful hemostasis.
