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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

Management of coexistent carotid and coronary artery disease

D P Halpin1, S Riggins, J D Carmichael

  • 1Department of Surgery, Baptist Medical Center-Princeton, Birmingham, Ala.

Southern Medical Journal
|February 1, 1994
PubMed

Insights

Simultaneous coronary artery bypass grafting and carotid endarterectomy (CE) is safe, even with bilateral carotid artery disease. This combined procedure for high-grade stenosis offers acceptable morbidity and mortality rates.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Coronary artery disease and carotid artery disease often coexist.
  • Surgical management of both conditions requires careful consideration of patient risk.
  • The safety of combined coronary artery bypass grafting (CABG) and carotid endarterectomy (CE) is a significant clinical question.

Purpose of the Study:

  • To evaluate the safety and outcomes of simultaneous CABG and CE.
  • To assess the impact of bilateral carotid artery disease on the combined procedure's morbidity and mortality.

Main Methods:

  • A retrospective review of 133 patients undergoing simultaneous CABG and CE over 8 years.
  • Carotid endarterectomy (CE) was performed before sternotomy for CABG under the same anesthesia.
  • Patient data included preoperative symptoms, degree of stenosis, and postoperative complications.

Main Results:

  • Overall postoperative stroke/TIA rate was 4.6% (3 strokes, 3 TIAs).
  • Mortality rate was 1.5% (2 deaths).
  • No significant difference in outcomes was observed in patients with bilateral carotid artery disease compared to those with unilateral disease.

Conclusions:

  • Simultaneous CABG and CE is a viable option for patients with significant coronary and carotid artery disease.
  • Bilateral carotid artery disease does not appear to increase the risk of stroke or mortality in this combined procedure.
  • The study supports the simultaneous repair of high-grade carotid stenosis and coronary artery disease.

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