SURVIVAL RATE IN PATIENTS WITH MULTIFOCAL ATHEROSCLEROSIS WHO UNDERWENT SURGICAL CAROTID AND CORONARY...

Area of Science:

• Cardiovascular Surgery
• Neurology
• Vascular Medicine

Background:

• Long-term outcomes of combined cerebral and coronary artery revascularization are not well-established.
• Atherosclerotic lesions in both cerebral and coronary arteries require complex treatment strategies.

Purpose of the Study:

• To determine long-term survival rates in patients with combined atherosclerotic cerebral and coronary artery lesions undergoing surgical revascularization.
• To compare survival functions across different revascularization methods, sequences, and timings.

Main Methods:

• Kaplan-Meier method for survival analysis from postoperative Day 30.
• Log-rank test for comparing survival functions among six patient groups.
• Comparison of alternative carotid and coronary territory revascularization methods.

Main Results:

• Similar 5-year survival for endovascular revascularization (stenting both territories) and combined surgery (coronary stenting + carotid endarterectomy).
• Higher 5-10 year survival in the combined surgery group (p=0.026).
• No significant difference in 10-year survival between sequential cerebral stenting then coronary bypass grafting and simultaneous carotid endarterectomy + coronary bypass grafting (p=0.532).

Conclusions:

• Combined surgical revascularization may offer better long-term survival for patients with combined cerebral and coronary artery disease.
• Cardiac or cerebral events were the primary causes of death across all groups.
• Findings can guide the selection of surgical tactics, sequence, and timing for revascularization procedures.