Safe intraluminal shunting during carotid endarterectomy.

The major complications associated with shunting include embolization at the time of insertion and shunt thrombosis. Increased technical difficulty of performing the endarterectomy with an inlying shunt hs also contributed to lack of surgeon acceptance. These problems can be minimized by using a short, flexible shunt with a sidearm attachment. The shortness enables the shunt to lie within the vessel, while the flexibility enables manipulation of the shunt to optimize exposure of all segments of the vessel. The sidearm allows flushing of both limbs and helps prevent embolization while providing a means for rapid assessment of shunt patency. The technique provides a safe and simple method of shunting during carotid endarterectomy.