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Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
07:46

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

Is carotid artery disease responsible for perioperative strokes after coronary artery bypass surgery?

Yuebing Li1, John Castaldo, Jan Van der Heyden

  • 1Division of Neurology, Lehigh Valley Health Network, Allentown, PA 18103, USA.

Journal of Vascular Surgery
|December 15, 2010
PubMed

Insights

Simultaneous carotid endarterectomy and coronary artery bypass surgery may be safe but evidence for necessity is debated. Further clarification is needed to justify combined procedures for patients with both coronary and carotid disease.

Area of Science:

  • Vascular Surgery
  • Neurology
  • Cardiology

Background:

  • Coronary and extracranial carotid arteries are frequently affected by atherosclerotic disease.
  • Stroke is a significant complication of coronary artery surgery.
  • Simultaneous revascularization of both vascular beds is reported but necessity is debated.

Purpose of the Study:

  • To clarify the evidence justifying simultaneous carotid endarterectomy and coronary artery bypass surgery.
  • To evaluate the necessity of combined procedures in patients with comorbid coronary and carotid disease.

Main Methods:

  • Review of existing vascular surgery literature.
  • Analysis of evidence regarding perioperative stroke causes.
  • Discussion of treatment outcomes in patients with dual vascular disease.

Main Results:

  • Simultaneous coronary and carotid revascularization is generally reported as safe.
  • Evidence supporting the necessity of combined procedures remains circumstantial.
  • Multiple stroke etiologies exist in coronary bypass patients, complicating outcome analysis.

Conclusions:

  • The necessity of simultaneous carotid endarterectomy and coronary artery bypass surgery requires further investigation.
  • Distinguishing stroke causes in patients with both coronary and carotid disease is challenging.
  • More evidence is needed to definitively justify combined surgical approaches.

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