- •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.
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.
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.
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.
Shunting was found to be associated with higher rates of postoperative complications in both symptomatic and asymptomatic patient populations.
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Published online: January 25, 2023
Accepted: January 22, 2023
Received in revised form: November 23, 2022
Received: August 8, 2022
Publication stageIn Press Journal Pre-Proof
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