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Staged carotid artery stenting and coronary artery bypass graft surgery: Initial results from a single center
- Source :
- Catheterization and Cardiovascular Interventions. 67:142-148
- Publication Year :
- 2005
- Publisher :
- Wiley, 2005.
-
Abstract
- The objective of this study was to assess the clinical course of patients undergoing planned percutaneous carotid stenting followed by staged coronary artery bypass grafting (CABG). Coexisting carotid and coronary atherosclerotic disease is relatively common. A combined or staged surgical approach has a composite stroke, myocardial infarction, or death rate of > 10%. We performed a retrospective search of our single-institution database to identify all patients scheduled to undergo staged carotid stenting followed by CABG. Twenty-three such patients (17 males, 6 females) were identified, with 3/23 (13%) requiring bilateral carotid stenting. Most carotid lesions were asymptomatic (18/26; 69.2%) and severe (mean stenosis, 82.9% 6+/- 8.6%). Stents were successfully placed in 26/26 carotid arteries (100%). One stent procedure (1/26; 3.8%) resulted in a minor stroke, but full recovery occurred within 1 week. There were no other peri-stenting complications. Three patents (3/23; 13%), none of whom suffered an adverse event at carotid stenting, elected not to undergo CABG. The mean interval from last carotid stent to CABG was 69.6 6 +/- 39.6 days (range, 8-157 days). Antiplatelet therapy was ceased > 3 days prior to CABG in 10/20 patients (50%), but continued until surgery in the remainder. There were no peri-CABG bleeding or neurological complications, but one myocardial infarction occurred (1/20; 5%). Therefore, of the 20 patients who underwent planned carotid stenting followed by CABG, our overall rate of death, stroke, or myocardial infarction was 10%. However, our rate of death, persistent stroke or myocardial infarction was 5%. Planned carotid stenting followed by staged CABG is a viable method of treatment for patients with coexistent carotid and coronary atherosclerosis.
- Subjects :
- Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
Coronary Disease
Comorbidity
Postoperative Complications
Internal medicine
Carotid artery disease
Humans
Medicine
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Myocardial infarction
Coronary Artery Bypass
Stroke
Coronary atherosclerosis
Aged
Retrospective Studies
business.industry
Coronary Stenosis
Stent
General Medicine
Middle Aged
medicine.disease
Surgery
Stenosis
surgical procedures, operative
cardiovascular system
Cardiology
Female
Stents
Carotid stenting
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 1522726X and 15221946
- Volume :
- 67
- Database :
- OpenAIRE
- Journal :
- Catheterization and Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....e776edda997b530e1131b2bf69384295