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Updated: Sep 21, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Synchronous carotid stenting and cardiac surgery: an initial single-center experience
Oscar Mendiz1, Mendiz Oscar, Carlos Fava
1Department of Interventional Cardiology, Fundación Favaloro, Buenos Aires, Argentina. omendiz@ffavaloro.org
Insights
Synchronous carotid stenting and cardiac surgery is a feasible approach for high-risk patients. This strategy demonstrated an acceptable complication rate, offering an alternative to staged procedures for concurrent carotid and cardiac disease.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Surgery
Background:
- Concurrent severe carotid and cardiac disease presents a complex surgical challenge.
- Staged surgical procedures are common but remain controversial for these patients.
Purpose of the Study:
- To evaluate the in-hospital and midterm outcomes of synchronous carotid stenting and cardiac surgery.
- To assess the feasibility and complication rates of this combined approach.
Main Methods:
- 30 high-surgical-risk patients underwent carotid stenting followed immediately by cardiac surgery.
- Patients received aspirin and unfractionated heparin (UFH) during stenting, and dual antiplatelet therapy post-operatively.
- In-hospital and midterm follow-up data were collected and analyzed.
Main Results:
- In-hospital complications included three surgical deaths and one transient ischemic attack (TIA).
- No strokes or myocardial infarctions occurred during hospitalization.
- Midterm follow-up showed no strokes or reinterventions, with two non-procedure-related deaths.
Conclusions:
- Synchronous carotid stenting and cardiac surgery is a viable option for carefully selected high-risk patients.
- This combined approach offers an acceptable complication rate, particularly for those unable to undergo staged procedures.
Abstract:
Concurrent severe carotid and cardiac disease is a challenging situation where staged surgery is probably the most common strategy, although it is still controversial. We report in-hospital and midterm outcome of 30 patients who received carotid stenting and synchronous cardiac surgery. All received carotid stenting under aspirin and regular unfractioned heparin (UFH) and were immediately transferred to the operating room for coronary and/or cardiac valve surgery. All patients received aspirin and clopidogrel once bleeding was ruled out, after surgery. In-hospital complications were: three surgical related deaths, one TIA, and no patient suffered stroke or myocardial infarction. Hospital stay was 14 +/- 11.8 days. Survivors were followed for 18.4 +/- 14 months. There were two non-related deaths, but no stroke nor cardiac or carotid reinterventions. In conclusion, this small series showed that synchronous carotid stenting and cardiac surgery was feasible with an acceptable complication rate in a high-surgical-risk population which could not undergo staged procedures.
