[Usefulness of coronary angiography in patients undergoing carotid endarterectomy]

We evaluated 37 cases of coronary angiography in patients undergoing carotid endarterectomy (CEA). The severity of coronary stenosis was estimated by Gesini's scoring system. There was no correlation between the severity of carotid stenosis and that of coronary stenosis, but those patients who had a history of coronary artery disease, carotid bruit or intracranial artery stenoses presented significant severe coronary stenosis in most cases. Even in the patients who had no history of coronary artery disease (n = 26), 13 patients (50%) had stenotic lesions shown by coronary angiography. Eight patients required treatment for their coronary stenotic lesions: 5 were treated with percutaneous transluminal coronary angioplasty (PTCA) and 3 with coronary artery bypass grafting. Intraoperative occlusion tests monitored by EEG and SEP showed abnormal findings in 6 CEA operations. One of these patients received PTCA before CEA, and had a good clinical course during and after the CEA procedure. In conclusion, in patients undergoing CEA there is frequently concomitant coronary artery stenosis. We should thus assess the coronary artery lesion more precisely by coronary angiography, and should carry out prophylactic treatment for these lesions.