Fixative method of carotid shunt using a Sugita's fenestrated aneurysm clip as a device in carotid endarterectomy: technical note

Abstract Backgroud Difficulty for distal exposure of the ICA is sometimes encountered during CEA. A carotid shunt is used to maintain sufficient cerebral blood flow during CEA but requires fixative materials, such as a string or a metallic ring, which often restrict the operative field, especially that of the distal ICA. Methods Here, we describe a novel technique for carotid shunt fixation using a unique fixative device in CEA. In the method presented here, the carotid shunt is fixed with an inflated balloon and a conventional vascular tourniquet proximally, but distal fixation is achieved using a Sugita's fenestrated clip that catches the mid portion of the carotid shunt and surrounding tissue. Results and Conclusion The device prevents the distal carotid shunt slipping out of the distal ICA. The present method allows mobilization of the shunt position during CEA and facilitates far-distal exposure of the ICA.