2010
DOI: 10.1155/2010/816937
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Distal Cervical Carotid Artery Dissection after Carotid Endarterectomy: A Complication of Indwelling Shunt

Abstract: The technical factors and surgical methods employed in carotid endarterectomy are controversial. In particular, whether or not to use an indwelling arterial shunt during carotid endarterectomy remains a source of conflict. We describe a rare case in which uncomplicated carotid endarterectomy was followed by distal internal carotid artery dissection and suggest that this devastating complication was due to intimal damage produced by the use of an indwelling arterial shunt.

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Cited by 10 publications
(7 citation statements)
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“…[ 1 ] However, only four cases of distal CAD due to an indwelling shunt have been reported. [ 9 , 10 , 16 ] In our case, CAD started at the tip of the elongated styloid process apart from the distal end of the endarterectomy, which coincided to the site where the balloon of the shunt was inflated. We estimated this pathophysiology to be caused by the mechanical conflict of the inflated balloon with the elongated styloid process, an etiology similar to that in the vascular Eagle syndrome.…”
Section: Discussionmentioning
confidence: 63%
See 1 more Smart Citation
“…[ 1 ] However, only four cases of distal CAD due to an indwelling shunt have been reported. [ 9 , 10 , 16 ] In our case, CAD started at the tip of the elongated styloid process apart from the distal end of the endarterectomy, which coincided to the site where the balloon of the shunt was inflated. We estimated this pathophysiology to be caused by the mechanical conflict of the inflated balloon with the elongated styloid process, an etiology similar to that in the vascular Eagle syndrome.…”
Section: Discussionmentioning
confidence: 63%
“…[ 6 , 12 , 13 ] A dissection beginning from a point distal to the endpoint of the endarterectomy is called distal carotid artery dissection (CAD), which is known as one of the significant surgical complications of CEA. [ 9 , 10 , 16 ]…”
Section: Introductionmentioning
confidence: 99%
“…[ 18 ] Moreover, there are some reports on internal carotid artery dissection due to shunt insertion. [ 19 , 20 ] However, it is debatable whether routine shunting or elective shunting can prevent complications. A previous report revealed no significant difference in terms of mortality and morbidity.…”
Section: Discussionmentioning
confidence: 99%
“…There are publications describing serious complications after shunt application [20,21]. A limitation of the above methods is their application after qualification and the beginning of the CEA, which limits the possibility of using endovascular treatment where the fact of CC intolerance is not so important.…”
Section: Discussionmentioning
confidence: 99%