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Combined carotid endarterectomy and coronary bypass: a decade experience at UCLA
M M Farooq1, T D Reil, H A Gelabert
1University of California Los Angeles, Division of Vascular Surgery, Gonda (Goldschmied) Vascular Center, 200 Medical Plaza, Suite 510-6, Box 956908, Los Angeles, CA 90095-6908, USA. mfarooq@mednet.ucla.edu
Purpose:
The purpose of this review was to determine outcomes for combined carotid endarterectomy (CEA) and coronary revascularization (CABG) in patients with asymptomatic carotid stenosis.
Methods:
We reviewed the medical records of consecutive combined procedures (CEA and CABG), performed at UCLA Medical Center from October, 1989 to January, 1999.
Findings:
There were 43 patients, 27 men and 16 women, with a mean age of 71 yr (range 51-87). Thirty-four patients 79% (34/43) had asymptomatic carotid stenosis. Stroke occurred in three patients (3/43 = 6.9%). Stroke ipsilateral to the CEA occurred in two patients: one asymptomatic (1/34 = 2.9%) and one symptomatic (1/9 = 11.1%).
Conclusions:
The majority of patients undergoing combined CEA/CABG have asymptomatic carotid stenosis identified in preparation for elective CABG. The asymptomatic carotid subset stroke rate of 2.9% resulting from a combined CEA/CABG is higher than our reported rate for CEA performed alone. In patients with asymptomatic carotid stenosis, the combined procedure should be selectively performed.
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