Hemodynamic performance of carotid artery shunts.

Abstract:

:Although the use of shunts for carotid artery surgery remains controversial, the hemodynamics of the shunts currently available have not been carefully evaluated in vivo. We developed an animal model using contralateral carotid artery ligation, which produced ipsilateral carotid blood flows (640 +/- 44 ml/min) and internal carotid stump pressures (52 +/- 4 mm Hg) over a range commonly seen in carotid artery surgery. Seven shunts were tested and included Javid; 10F and 8F Brener; and 14F, 12F, 10F, and 8F Argyle shunts. The hemodynamic features evaluated for each shunt included maximum shunt flow, the pressure gradients occurring across each shunt, the increase in cerebral perfusion pressure over occlusion pressure associated with shunt placement, and the distal pressure pulse waveform. The larger diameter shunts were consistently better than the smaller diameter shunts. The correlation between shunt flow and the increase in distal pressure produced by shunt placement was high (r = 0.98, p less than 0.05), confirming that high flow rates maintained high perfusion pressure. By relating maximum shunt flow and the pressure gradient to the change in the pressure pulse contour for each shunt, it could be demonstrated that at the larger diameters, straight shunts displayed superior hemodynamic characteristics compared with tapered shunts, whereas at smaller diameters, tapered shunts were superior.

journal_name

Am J Surg

authors

Aufiero TX,Thiele BL,Rossi JA,Miller CA,Neumyer MM

doi

10.1016/0002-9610(89)90354-1

subject

Has Abstract

pub_date

1989-08-01 00:00:00

pages

95-9; discussion 100

issue

2

eissn

0002-9610

issn

1879-1883

pii

0002-9610(89)90354-1

journal_volume

158

pub_type

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