Carotid endarterectomy and the Javid shunt: the early results of 215 consecutive operations for transient ischaemic attacks.

This paper describes a consecutive series of 215 carotid bifurcation endarterectomies performed by one surgeon for transient ischaemic attacks. One patient died from a pulmonary embolism (0.47 per cent). One patient developed a permanent stroke related to the contralateral hemisphere 3 days after operation (0.47 per cent). Five patients developed a weakness of one arm or hand which had clinically recovered 2 months after operation (2.35 per cent); four patients had a transient weakness of one arm or hand which had recovered in less than 24 h of the operation. There were no serious ocular complications. The incidence of serious permanent complications was therefore 0.94 per cent. The Javid shunt could not be used in only 4 of the 193 operations in which its insertion was attempted. It caused arterial damage in only one patient. The results suggest that the routine use of the shunt was of value and that carotid endarterectomy can be a safe, relatively complication-free, procedure.