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Management of patients with concomitant severe coronary and carotid artery disease: is there a perfect solution?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Roffi, Marco |
| Copyright Year | 2007 |
| Abstract | Despite limited evidence of the benefit of carotid revascularization before or together with coronary artery bypass grafting (CABG), patients with advanced carotid and coronary disease are frequently treated by a combined or staged carotid/coronary surgical revascularization. In the present issue of Circulation,1 investigators from Nieuwegein in the Netherlands describe in a large group of patients (n 356) an alternative revascularization approach: carotid artery stenting (CAS) followed by CABG. The rate of death, stroke, or myocardial infarction (MI) from the time of CAS to 30 days after cardiac surgery (6.8%) compares well with previous surgical series2–21 (Table). The associated neurological complication rates were low both at 30 days (major ipsilateral stroke 1.1%) and at a mean follow-up of 31 months (neurological death 1.1% and major ipsilateral stroke 1.1%). The carotid restenosis rate was negligible. The authors must be commended for the favorable patient outcomes and for the volume of procedures performed (47 per year), which are superior to most, if not all, recent surgical series of combined coronary-carotid revascularization (Table). Additional important aspects of the study were that patients were accepted for CAS by a consensus decision that involved neurologists, surgeons, and interventionists and that neurologists were deeply involved in the care of those patients throughout the hospital stay. |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/116/18/2002.full.pdf?download=true |
| PubMed reference number | 17967987v1 |
| Volume Number | 116 |
| Issue Number | 18 |
| Journal | Circulation |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Arteriopathic disease Carotid Arteries Carotid Artery Diseases Cerebrovascular accident Cessation of life Coronary Artery Bypass Surgery Coronary heart disease Myocardial Infarction Patients restenosis revascularization |
| Content Type | Text |
| Resource Type | Article |
