The contribution of the external carotid artery to cerebral blood flow was evaluated in eight patients undergoing carotid endarterectomy. With restoration of external carotid artery flow, the internal carotid artery back pressure was augmented by an average of 20.9%. This represented a mean rise in internal carotid artery back pressure of 10.8 mm Hg, a median rise of 12.8 mm Hg, and a range of 0 to 17.5 mm Hg rise in pressure. To provide cerebral protection during carotid endarterectomy, an external carotid artery shunt was utilized in four patients without technical difficulty and with satisfactory operative results. In selected cases this modality of cerebral protection may be a valuable adjunct in the performance of carotid endarterectomy.
Machleder HI, Barker WF. External Carotid Artery Shunting During Carotid EndarterectomyEvidence for Feasibility. Arch Surg. 1974;108(6):785-788. doi:10.1001/archsurg.1974.01350300027007