ABSTRACT
Repair with Shunt in Place In this case, the ICA repair is nearly complete and only the CCA and bulb portions of the shunt are visible. Note that the black dot continues to mark the midpoint of the arteriotomy. In this procedure, the Rummel tourniquet did not prove adequate to secure the shunt without some degree of minor, but annoying, antegrade bleeding, and a large Javid clamp was placed around the CCA as a backup. This was an unusual occurrence since the vessel loop or 0 silk encased in the Rummel tourniquet typically stops bleeding around the shunt.
