Editor-in-Chief Ufuk Demirkılıç Frequency Quarterly Abbreviation Turk J Vasc Surg Publisher Turkish National Vascular and Endovascular Surgery Society ISSN 2667-4947 E-ISSN 2667-5080

Turkish Journal of Vascular Surgery 2021 , Vol 30 , Issue 2
Can ankle-brachial index be used as a predictor for carotid artery shunt application during carotid endarterectomy?
Mehmet Akif Önalan1, Didem Melis Öztaş2, Ayşenur Önalan3, Metin Onur Beyaz4, Siraslan Bahseliyev5, Zerrin Sungur6, Ömer Ali Sayın7, Murat Uğurlucan4
1Department of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, Atakent Hospital, Istanbul, Turkey
2Department of Cardiovascular Surgery, Bağcılar Training and Research Hospital, Istanbul, Turkey
3Department of Neurology, Istinye University Faculty of Medicine, Liv Hospital, Istanbul, Turkey
4Department of Cardiovascular Surgery, Medipol University Faculty of Medicine, Istanbul, Turkey
5Department of Cardiovascular Surgery, Mehmet Akif Ersoy Training and Research Hospital, Istanbul, Turkey
6Department of Anesthesiology and Reanimation, Istanbul University Faculty of Medicine, Istanbul, Turkey
7Department of Cardiovascular Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey
DOI : 10.9739/tjvs.2021.924 Objectives: This study aims to investigate the possible relationship between low ankle-brachial index (ABI) and shunt requirement during carotid endarterectomy (CEA) operations.

Patients and methods: Medical records of a total of 56 patients (40 males, 16 females; mean age: 65.6±8.4 years; range, 48 to 82 years) who underwent CEA between January 2013 and December 2016 were retrospectively reviewed. The ABI was measured in all patients at the time of hospital admission. Peripheral arterial disease was defined as having an ABI of ≤0.90 in either leg. Selective carotid artery shunt strategy was applied to all patients who underwent CEA under regional anesthesia.

Results: Forty-eight (85.8%) patients were symptomatic. Peripheral arterial disease was diagnosed in 25 (44.6%) patients with ABI measurements. Eleven (19.6%) patients required shunt placement due to neurological deterioration during the carotid clamping test. The mean ABI of 11 (19.6%) patients was 0.8±0.15, while the ABI was less than 0.90 in 10 (17.8%) patients. There was a statistically significant correlation between perioperative shunt usage and peripheral arterial disease (odds ratio [OR]: 19.68, 95% confidence interval [CI]: 2.3-164.4; p=0.001).

Conclusion: Low ABI appears to be related to a higher rate of shunt requirement in patients undergoing CEA under regional anesthesia with a selective shunt strategy in our modest cohort. Keywords : Ankle-brachial index, carotid artery shunting, carotid endarterectomy

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