Patch angioplasty versus primary closure for carotid endarterectomy. Patch angioplasty versus primary closure for. Landry, Results of routine shunting and patch closure during carotid endarterectomy. Patch Closure Improves Results with Carotid Endarterectomy. Prospective randomized trial of carotid endarterectomy with primary closure and patch vein. Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting)Question. We wanted to compare the effect of routine shunting versus selective or no shunting during carotid endarterectomy, and to assess the effect of different methods for selection of people for shunting. Background. About 2. Carotid endarterectomy is an operation to remove this narrowing and therefore reduce the risk of stroke. However, there is a 5% to 1. The use of a silicon tube, or shunt, as a temporary bypass can reduce the length of time that blood flow to the brain is interrupted during the operation. This may reduce the risk of perioperative stroke but could also result in arterial wall damage and therefore increase the risk of stroke. Although patch angioplasty closure is routine in all. We evaluate the durability of the primary closure and the safety of selective shunting during carotid endarterectomy. Carotid Atherosclerotic Plaque Characteristics Are Associated With Microembolization During Carotid Endarterectomy and Procedural. Shunt surgery falls into three categories. Firstly, in routine shunting, the surgeon inserts a shunt in every patient. Secondly, in selective shunting, the surgeon only uses a shunt in patients with an inadequate blood supply to the brain following clamping; various cerebral monitoring techniques, such as ultrasound for predicting who needs a shunt, have been used in this policy. Thirdly, in no shunting, surgeons do not employ shunts at all. Study characteristics. We identified six studies up to August 2. These studies included a total of 1. Three of the trials compared routine shunting with no shunting, one trial compared routine shunting versus selective shunting, and another two trials compared different methods of monitoring in selective shunting. We have not yet identified any trials that compared selective shunting with no shunting. All the included trials assessed the use of shunting in people undergoing endarterectomy under general anaesthetic. The age of the participants ranged from 4. Where reported, participants were followed up for no longer than 3. Key results. There is still no evidence for the use of a carotid shunt during carotid endarterectomy. This review suggests a benefit from the use of a shunt, but the overall results were not statistically significant. More trials are needed. Quality of the evidence. There were significant problems with the quality of the randomised trials and, overall, the reporting of study methodology was poor.
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January 2017
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