{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:13:17Z","timestamp":1792267997742,"version":"4.4.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T00:00:00Z","timestamp":1104537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vascular"],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:p>Carotid endarterectomy (CEA) is an effective treatment for significant carotid atherosclerosis. Perioperative stroke, a devastating complication, may be partially circumvented by shunting. However, routine shunt use is not without complications and does not benefit every patient. Our study is designed to determine whether CEA under general anesthesia, without cerebral monitoring, can be safely done with shunting only in the presence of poor internal carotid artery back-bleeding or contralateral carotid occlusion or critical stenosis.<\/jats:p>\n                  <jats:p>The medical records of 995 carotid operations were reviewed. A subset of 117 operations was performed on 112 patients using selective shunting. Data were analyzed and outcomes compared.<\/jats:p>\n                  <jats:p>\n                    For the selective shunt group, indications for redo operations (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 13) were recurrent asymptomatic high-grade stenosis in 69% and amaurosis fugax or transient ischemic attack in 31%. Indications for primary CEA (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 104) were asymptomatic high-grade stenosis in 59%, amaurosis fugax or transient ischemic attack in 36%, previous stroke in 3%, and global ischemia in 2%. A selective shunt was used in 29% of all symptomatic and 11% of all asymptomatic patients. No cerebral monitoring was used. There were no perioperative deaths and no permanent cranial nerve injuries, and there was one stroke (0.8%) from postoperative carotid thrombosis in a shunted patient. The average length of stay was 1.6 days for the non-shunt group and 2.2 days for the shunt group. The routine shunt group (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 878) had an overall stroke rate of 0.7%, no permanent cranial nerve deficits, and a mean hospital stay of 2.6 days.\n                  <\/jats:p>\n                  <jats:p>CEA under general anesthesia with selective shunting can be performed safely without cerebral monitoring.<\/jats:p>","DOI":"10.1258\/rsmvasc.13.1.23","type":"journal-article","created":{"date-parts":[[2011,2,15]],"date-time":"2011-02-15T19:12:37Z","timestamp":1297797157000},"page":"23-27","source":"Crossref","is-referenced-by-count":14,"title":["Selective Shunting during Carotid Endarterectomy"],"prefix":"10.1177","volume":"13","author":[{"given":"Thelinh Q.","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Lind","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"E. John","family":"Harris","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Stanford University School of Medicine, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2005,1]]},"reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03520420037035"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92916-P"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108153250701"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811123392002"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.1.188"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01561267"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01561265"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198006000-00008"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197706000-00010"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1017\/S031716710002624X"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198306000-00009"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198311000-00014"},{"key":"e_1_3_1_14_2","first-page":"353","volume-title":"Angiology: strategy for diagnosis and therapeutics","author":"Schweiger H","year":"1988","unstructured":"SchweigerHKampH-DDinkelMBoccalonHSomatosensory evoked potentials (SEP) during carotid endarterectomy\u2014end of shunt debate?Angiology: strategy for diagnosis and therapeutics1988ParisJohn Libbey Eurotext3535"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198602000-00014"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01405270"},{"key":"e_1_3_1_17_2","first-page":"673","article-title":"Awake patient monitoring to determine the need for shunting during carotid endarterectomy","volume":"114","author":"Benjamin ME","year":"1993","unstructured":"BenjaminMESilvaMBWattCAwake patient monitoring to determine the need for shunting during carotid endarterectomySurgery1993114673818211681","journal-title":"Surgery"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197709000-00011"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(85)90121-1"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2001.1341"},{"key":"e_1_3_1_21_2","first-page":"168","article-title":"Is transcranial Doppler a worthwhile examination for preoperative evaluation of the circle of Willis? Evaluation of 137 carotid endarterectomies performed under regional anesthesia","volume":"17","author":"Lagneau P","year":"1998","unstructured":"LagneauPBaujatBAnidjarSIs transcranial Doppler a worthwhile examination for preoperative evaluation of the circle of Willis? Evaluation of 137 carotid endarterectomies performed under regional anesthesiaInt Angiol199817168709821030","journal-title":"Int Angiol"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02693795"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198506000-00017"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03013950"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(05)80167-4"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(87)90157-1"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(99)00070-8"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.159.5.1414775"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/096721099900700107"}],"container-title":["Vascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/rsmvasc.13.1.23","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1258\/rsmvasc.13.1.23","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/rsmvasc.13.1.23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:33:00Z","timestamp":1767677580000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1258\/rsmvasc.13.1.23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,1]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2005,1]]}},"alternative-id":["10.1258\/rsmvasc.13.1.23"],"URL":"https:\/\/doi.org\/10.1258\/rsmvasc.13.1.23","relation":{},"ISSN":["1708-5381","1708-539X"],"issn-type":[{"value":"1708-5381","type":"print"},{"value":"1708-539X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,1]]}}}