The following is a summary of “Comparing carotid endarterectomies with or without shunting in symptomatic and asymptomatic patients,” published in the JULY 2023 issue of Surgery by Soliman, et al.

Recent research has raised concerns about using intraluminal shunts during carotid endarterectomy (CEA) surgeries, as they may be associated with postoperative complications. Researchers sought to compare CEA operations with or without shunting for a study to investigate their clinical outcomes.

The National Surgical Quality Improvement Program (NSQIP) database of the American College of Surgeons was examined for 13,736 patients between 2016 and 2019. The study compared adult patients with symptomatic and asymptomatic carotid stenosis who underwent a CEA operation, with or without shunt placement.

In patients with symptoms who underwent shunting during the carotid endarterectomy, the incidence of stroke with neurological deficit (P = 0.012), myocardial infarction (P = 0.021), and urinary tract infection (P = 0.030) was higher compared to those without shunting. Furthermore, the multivariate logistic regression analysis demonstrated that the risk of complications, including cerebrovascular neurological injury (CNI), was significantly higher in both symptomatic (93.63%, P < 0.001) and asymptomatic (69.58%, P = 0.001) patients who received shunting, regardless of other confounding variables.

Shunting during carotid endarterectomy was associated with higher rates of postoperative complications in both symptomatic and asymptomatic patient populations. The findings highlighted the importance of careful consideration and assessment of the use of intraluminal shunts during CEA surgeries to minimize the risk of adverse outcomes.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00025-9/fulltext