Although intraarterial shunting during carotid endarterectomy is a well-defined practice, its use remains controversial. Complication rates associated with shunt placement remain low, but may be underreported. When complications secondary to routine intraarterial shunting occur, they can cause significant morbidity or even mortality, emphasizing the importance of meticulous technique to prevent adverse outcomes. We report a case of internal carotid artery dissection and pseuedoaneurysm due to the technical failure of a safety device of an intraarterial shunt used during carotid endarterectomy.
AbuRahmaAMousaAStoneP. Shunting during carotid endarterectomy. J Vasc Surg. 2011;54(5):1502–1510.
2.
JavidHJulianODyeWHunterJ. Seventeen-year experience with routine shunting in carotid artery surgery. World J Surg. 1979;3(2):167–177.
3.
SchiroJMertzGCannonJCintoraI. Routine use of a shunt for carotid endarterectomy. Am J Surg. 1981;142(6):735–738.
4.
BellostaFLuzzaniLCarugatiCTalaricoMSarcinaA. Routine shunting is a safe and reliable method of cerebral protection during carotid endarterectomy. Ann Vasc Surg. 2006;20(4):482–487
5.
TriosiNDorigoWPulliFPratesiC. A case of traumatic internal carotid artery aneurysm secondary to carotid shunting. J Vasc Surg. 2010;51(1):225–227.
6.
EidtJKahnMBaroneGCookJMBarnesRW. Malfunction of a double-balloon carotid shunt as a result of herniation of the proximal balloon. J Vasc Surg. 1990;12(1):62–64.
7.
PlestisKLoubserPMizrahiE. Continuous electroencephalographic monitoring and selective shunting reduces neurologic morbidity rates in carotid endarterectomy. J Vasc Surg. 1997;25(4):620–628.
8.
SchneiderJDrosteJSchindlerN. Carotid endarterectomy with routine electroencephalogrphy and selective shunting: influence of contralateral internal carotid artery occlusion and utility in prevention of perioperative strokes. J Vasc Surg. 2002;35(6):1114–1122.
9.
BandykDThieleB. Safe intraluminal shunting during carotid endarterectomy. Surgery. 1983;93(2):260–263.
10.
LoftusCDysteGReinarzSHingtgenW. Distal cervical carotid dissection after carotid endarterectomy: a complication of indwelling shunt?Neurosurgery. 1986;19(3):441–445.
