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Published on: May 9, 2013

Simultaneous carotid endarterectomy and coronary artery bypass surgery in Canada

M D Hill1, F M Shrive, J Kennedy

  • 1Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Alberta, Canada. michael.hill@calgaryhealthregion.ca

Neurology
|April 27, 2005
PubMed

Insights

Simultaneous carotid endarterectomy (CEA) with coronary artery bypass grafting (CABG) in Canada showed a 2.67-fold increased risk of stroke and death compared to CABG alone. Further randomized trials are needed to confirm these findings.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Patients needing coronary artery bypass grafting (CABG) often have comorbid severe carotid stenosis.
  • Simultaneous carotid endarterectomy (CEA) may be offered to these patients.
  • The safety and efficacy of combined CEA-CABG require further investigation.

Purpose of the Study:

  • To evaluate the stroke and death rates associated with combined CEA-CABG compared to CABG alone.
  • To assess the incidence of combined CEA-CABG procedures in Canada.

Main Methods:

  • Retrospective analysis of Canadian surgical data.
  • Comparison of adjusted stroke and death rates between combined CEA-CABG and CABG alone groups.

Main Results:

  • In Canada, 0.51% of CABG procedures involved a simultaneous CEA.
  • The adjusted stroke and death rate was 2.67 times higher in the combined CEA-CABG group than in the CABG alone group.

Conclusions:

  • Combined CEA-CABG procedures are associated with significantly higher adjusted stroke and death rates.
  • Randomized controlled trials are necessary to definitively assess the risks and benefits of simultaneous CEA-CABG.

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