Risk Factors and Implications of the Unplanned Shunt in Carotid Endarterectomy

In this cohort, prior stroke, beta-blocker use, and thrombolytic therapy were independently associated with unplanned shunt use during CEA. Among these, thrombolytic exposure prior to CEA conferred the greatest risk. This suggests that combinations of these high-risk factors could potentially guide preoperative decision-making for selective shunting surgeons, minimizing intraoperative stress and cerebral ischemia time.