Carotid Endarterectomy without Internal Shunt in 83 Cases

  • Shunro Endo
  • Akira Takaku
Conference paper


We have experienced 83 cases of carotid endarterectomy without internal shunt. These operations have been performed over the last 5 years and have been follow-up after more than 1 year. The operative mortality and morbidity rate was 0% in this series. No unconventional operative techniques or anesthesia besides the administration of 20% mannitol before and during carotid artery occlusion were employed. This report presents three subjects: characteristic clinical features of atherosclerotic extracranial carotid lesion in Japanese, the significance of administering 20% mannitol, and the surgical indication for cases with severe stenosis and showing progressing neurological symptoms.


Internal Carotid Artery Collateral Circulation Carotid Endarterectomy Severe Stenosis Internal Carotid Artery Stenosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Barnett HJM, Plum F, Walton JN (1984) Carotidendarterectomy—An expression of concern: Stroke 15:941–943PubMedCrossRefGoogle Scholar
  2. 2.
    Duke LJ, Slymaker EE, Lamberth WC, Wright CB (1979) Carotid arterial reconstruction: Ten years experience. Am Surg 45:281–288PubMedGoogle Scholar
  3. 3.
    Gaul JJ, Marks SJ, Weinberger J (1986) Visual disturbance and carotid artery disease. Stroke 17:393–398PubMedCrossRefGoogle Scholar
  4. 4.
    Jafar JJ, Johns LM, Mullan SF (1986) The effect of mannitol on cerebral blood flow. J Neurosurg 64:754–759PubMedCrossRefGoogle Scholar
  5. 5.
    McKay RD, Sundt TM, Michenfelder JD, Gronert GA, Messick JM, Sharbouth FW, Piepgras DG (1973) Internal carotid artery stump pressure and cerebral blood flow during carotid endarterectomy: Modification by helothane, enflurane, and innovar. Anesthesiology 45:390–399CrossRefGoogle Scholar
  6. 6.
    Ott DA, Cooley DA, Chapa L, Coelho A (1980) Carotid endarterectomy without temporary intraluminal shunt: Study of 309 consecutive operations. Ann Surg 191:708–714PubMedCrossRefGoogle Scholar
  7. 7.
    Spetzler RF, Martin N, Hadley MN, et al. (1986) Microsurgical endarterectomy under barbiturate protection. J Neurosurg 65:63–73PubMedCrossRefGoogle Scholar
  8. 8.
    Sundt TM, Sharbrouth FW, Anderson RE, Michenfelder JD (1974) Cerebral blood flow measurements and electroencephalograms during carotid endarterectomy. J Neurosurg 41:310–320PubMedCrossRefGoogle Scholar
  9. 9.
    Suzuki J, Yoshimoto T (1979) The effect of mannitol in prolongation of permissible occlusion time of cerebral artery. Neurosurg Ren 1:13–19CrossRefGoogle Scholar
  10. 10.
    Whisnant JP, Sandok BA, Sundt TM Jr (1983) Carotid endarterectomy for unilateral carotid system transient cerebral ischemia. Mayo Clin Proc 58:171–175PubMedGoogle Scholar

Copyright information

© Springer Japan 1988

Authors and Affiliations

  • Shunro Endo
    • 1
  • Akira Takaku
    • 1
  1. 1.Department of NeurosurgeryToyama Medical and Pharmaceutical UniversityToyamaJapan

Personalised recommendations