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Updated: Aug 14, 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
Off pump concomitant coronary revascularization and carotid endarterectomy
R B Beauford1, C R Saunders, D J Goldstein
1Department of Cardiothoracic Surgery, Newark Beth Israel Medical Center and Saint Barnabas Hospital, Newark, NJ 07112, USA.
Aim:
Off pump coronary revascularization has emerged as a viable option in the treatment of coexisting clinically significant carotid and coronary artery disease. To this end, we report our recent experience with combined carotid endarterectomy (CEA) and off pump coronary artery bypass (OPCAB).
Methods:
Our prospectively updated database was queried to identify all patients who underwent combined OPCAB/CEA between January 1, 1999 and December 31, 2002. A total of 38 patients were identified. They were subsequently compared to a contemporaneous cohort of isolated off-pump patients divided into those with and without cerebrovascular disease (CVD).
Results:
Mean age of the study population was 71+/-7.0 years, 23 patients (58%) had significant left main disease, 5 (13%) suffered a previous stroke and 5 (13%) had ejection fractions
Conclusion:
The optimal management of the multifocal atherosclerotic patient remains controversial and this dilemma is further clouded by the recent introduction of OPCAB, and more recently, carotid stenting. Our results suggest that combined OPCAB/CEA is safe and may reduce the risk of postoperative stroke. An economic benefit may also be inferred from shorter hospitalization as well as eliminating the need for another procedure. Randomization and long term follow-up are now required to verify these encouraging early findings.
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