Shunt-related internal carotid artery dissection during carotid endarterectomy: illustrative cases

Shunt-related dissection is a preventable complication requiring specific technical precautions, including ensuring symmetric balloon expansion, using a gentle insertion technique, and minimizing longitudinal movement. When dissection occurs, immediate endovascular stent placement may provide superior outcomes compared with conservative management, effectively preventing thromboembolic complications while achieving excellent functional recovery. https://thejns.org/doi/10.3171/CASE25697.