Highlights
- •Carotid endarterectomies carry an associated risk depending on the extent of arterial occlusion.
- •Shunting can lead to additional postoperative complications such as stroke or cranial nerve injury (CNI).
- •Shunting was found to increase the risk of CNI in both symptomatic and asymptomatic patients.
- •Symptomatic patients who underwent CEA with shunting had an increased risk of neurological deficit, myocardial infarction, and urinary tract infection.
Abstract
Background
Recent research shows that placement of an intraluminal shunt during a carotid endarterectomy
(CEA) can be associated with postoperative complications. Therefore, we compared CEA
operations with or without shunting to further analyze their clinical outcomes.
Methods
From the American College of Surgeons National Surgical Quality Improvement Program
(NSQIP) database, 13,736 cases between 2016 and 2019 were analyzed to compare adult
symptomatic and asymptomatic carotid stenosis patients who underwent a CEA operation,
with or without shunt placement.
Results
Rates of stroke with a neurological deficit (p = 0.012), myocardial infarction (p = 0.021),
and urinary tract infection (p = 0.030) were higher among symptomatic patients with
shunting. Multivariate logistic regression revealed that risk of CNI was higher among
both symptomatic (93.63%, p < 0.001) and asymptomatic (69.58%, p = 0.001) patients
with shunting, irrespective of confounding variables.
Conclusion
Shunting was found to be associated with higher rates of postoperative complications
in both symptomatic and asymptomatic patient populations.
Keywords
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Article info
Publication history
Published online: January 25, 2023
Accepted:
January 22,
2023
Received in revised form:
November 23,
2022
Received:
August 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
