PURPOSE: To present the senior author’s (BB) experience and views related to cervical carotid artery shunting during a 39-year experience of carotid intervention (CI). METHODS: Retrospective and prospective data related to BB's performance of carotid endarterectomy (CEA) and carotid stenting (CAS) with additional reference to our international published data on studies performed during that period (1,2). CAS (all per femoral) commenced in 2005 evolving to a “primary” stenting policy selecting patients unlikely to require balloon dilation and with multi-disciplinary involvement. RESULTS: From 2/1/1986 to date BB has performed 2677 CI (CEA: 2176; CAS: 501). Interventions per annum peaked at 134 in 1996 (all CEA). Symptomatic CEA: 76% CAS: 93%. CEA method changed from initial “all under GA and all shunted” (the first 468 consecutive cases of the series) through selective shunting using loco-regional anaesthesia (LRN) and from very rare patching through almost universal vein patching to Eversion CEA without patching (except for shunted patients). Total shunts inserted: 650. Shunt rate for CEA LRN: 10.8%, for CI: 5.0%. Our published data on DWI lesions associated with shunting will be discussed (2). CONCLUSION: There is no doubt that some brains are “shunt dependent” (SDB) but that does not necessarily prove a shunt is required during CEA. However, the observed behaviour of awake patients with SDB prior to the insertion of a shunt strongly suggests significant cerebral damage would occur without shunt support. A selection policy involving both CEA LRN and CAS reduces shunt requirement to a very low level. 1.Bourke and Crimmins: J Vasc Surg 2002, 36: 70-4 2.Bourke, Bourke and Beiles: Eur J Vasc Endovasc Surg (2016) 51, 167-173