Early outcomes of carotid endarterectomy without shunting in patients with complete occlusion of the contralateral internal carotid artery

Aim: Shunting in carotid endarterectomy (CEA) is a controversial issue, which remains to be clarified in patients with contralateral carotid occlusion (CCO). In our clinic, CEA is performed under general anesthesia and without shunting. The present study aimed to discuss 30-day mortality and morbidity outcomes of CEA performed without shunting on 53 CCO cases. Materials and Methods: In our clinic, 415 CEA procedures were performed on 376 patients between the years 2005 and 2013. Among these patients, 53 (39 males and 14 females) with CCO who underwent isolated CEA were included in the study. All patients were operated on without shunting and under general anesthesia. Results: Of the patients, 31 were symptomatic (mean age, 63.2 ΁ 5.1 years) and 22 were asymptomatic (mean age, 63.1 ΁ 6.7 years). One (1.9%) patient died of postoperative myocardial infarction. Another patient (1.9%) developed stroke due to intracranial hemorrhage on the postoperative 6 th day. Transient ischemic attack was observed in 2 (3.8%) patients. Eight (15.1%) patients developed ipsilateral transient peripheral nerve injury, 1 (1.9%) patient developed hoarseness, and 5 (9.4%) patients developed organic brain injury. Conclusion: It was observed that CEA without shunting could be performed with an acceptable risk ratio under general anesthesia in cases with CCO.