Related Experiment Video
Updated: Aug 11, 2026
Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
Published on: May 9, 2013
[Simultaneous carotid and coronary operations: experience and results of 11 years (1990-2000)]
1Semmelweis Egyetem Altalános Orvostudományi Kar, Er- és Szívsebészeti Klinika, 1122 Budapest, Városmajor utca 68. szabzol@webmail.hu
Insights
Simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy procedures in older patients with extensive disease had lower-than-expected mortality. Survival rates remained high, demonstrating the safety of these combined interventions when performed by experienced teams.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Surgical Outcomes
Context:
- Combined coronary artery bypass grafting (CABG) and carotid endarterectomy procedures are complex, often performed in elderly patients with significant comorbidities.
- From 1990-2000, 163 such procedures were analyzed, revealing a patient cohort with advanced obliterative arterial disease and a high proportion of emergency interventions.
Purpose:
- To evaluate the outcomes and survival rates of simultaneous coronary artery bypass grafting (CABG) and carotid endarterectomy.
- To assess the actual surgical lethality compared to predicted risk using the Euroscore model.
Summary:
- Patients undergoing combined CABG and carotid procedures were older (mean age 63.4 years) and had more extensive disease than those undergoing isolated CABG.
- Over 60% had disease in other anatomical regions, and half of the procedures were urgent/emergency, with unstable cardiac status in many.
- The mean Euroscore was 6.26, predicting 11.2% lethality, but actual surgical lethality was 7.36%.
Impact:
- 1, 5, and 10-year survival rates were 89%, 82%, and 68%, respectively.
- Most survivors were in NYHA class I-II post-procedure.
- Myocardial events were the primary cause of early and late deaths, suggesting that careful patient selection and experienced surgical teams can mitigate risks associated with these combined procedures.
Abstract:
Between 1990-2000 163 coronary + carotid procedures were performed. The mean age was 4 years higher than it was at patients underwent isolated CABG (63.4 y vs 59.8 y). Clinically proven obliterative artery diseases in other anatomical regions were also present in more than 60% of patients. The half of the procedures were performed under emergency and urgent circumstances. The cardiac status and the coronary morphology were found to be unstable in half of the patients. The "Euroscore" risk evaluation model was used for risk scoring. The mean score value was as high as 6.26. According to this the estimated surgical lethality could have been as high as 11.2%. The real surgical lethality value was far under this estimated level (7.36%). The 1, 5, 10 year survival rate were as high as 89%, 82%, 68% (Kaplan-Meier). The majority of the patients was in NYHA I-II at the end of the follow-up period. The majority of the early and late deaths were found to be myocardial in origin. The estimated surgical risk of the simultaneous procedures could be reduce by accepting of the severe surgical indications existing at this surgical field and with the availability of an experienced operating team.
More Related Videos
09:11Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
Published on: February 23, 2016
09:36A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
Published on: August 12, 2025
