Temporary shunt and carotid endarterectomy (review of literature)

A N Kazantsev,R A Vinogradov,M A Chernyavsky,V N Kravchuk,G G Khubulava

doi:10.24884/0042-4625-2021-180-3-81-86

Abstract

The main idea of this article is based on the uncertainty of the current recommendations, according to which a temporary shunt (TS) during carotid endarterectomy (CEE) can be used selectively, routinely, and even completely abandon its use. This statement is supported by the low level of evidence (class B) of the conclusion that indications for the use of TS are established only on the basis of a decrease in retrograde pressure in the internal carotid artery (ICA) and/or indicators of cerebral oximetry. Thus, the low efficiency of these procedures makes it possible not to use them at all.

Highlights

The main idea of this article is based on the uncertainty of the current recommendations, according to which a temporary shunt (TS) during carotid endarterectomy (CEE) can be used selectively, routinely, and even completely abandon its Казанцев А
This statement is supported by the low level of evidence of the conclusion that indications for the use of TS are established only on the basis of a decrease in retrograde pressure in the internal carotid artery (ICA) and/or indicators of cerebral oximetry
V., Varga A., Csobay-Novák C. et al Incomplete circle of Willis is associated with a higher incidence of neurologic events during carotid eversion endarterectomy without shunting // J Vasc Surg. 2018

Summary

Introduction

The main idea of this article is based on the uncertainty of the current recommendations, according to which a temporary shunt (TS) during carotid endarterectomy (CEE) can be used selectively, routinely, and even completely abandon its Казанцев А. Данное утверждение подкреплено низким уровнем доказательности (класс В) заключения о том, что показания для использования ВШ устанавливаются только на основе снижения ретроградного давления во внутренней сонной артерии (ВСА) и (или) показателей церебральной оксиметрии. G. Temporary shunt and carotid endarterectomy (review of literature). При этом ни один из методов (измерение ретроградного давления ВСА, церебральная оксиметрия) не может прогнозировать развитие интраоперационного ОНМК, что делает их применение малоинформативным.

Results

Conclusion