Carotid Artery Stenting before CABG: A Better Alternative to Treat Concomitant Coronary and Carotid Artery Disease

Main Article Content

Mahmoud Mohammed Moawed
Khaled Attia
Khaled Sobh

Keywords

coronary artery bypass graft, coronary artery disease, carotid stenosis, outcome

Abstract

Background: Atherosclerosis of the coronary and carotid arteries can be fatal. Stroke is a serious complication of coronary artery bypass graft surgery, and carotid artery dysfunction is a major risk factor for stroke (CABG).
Methods: Patients who met the criteria for CABG were included in this prospective cohort study of those with severe carotid artery stenosis (>70%). Complications 30 days after stenting, neurological complications during cardiac surgery, rates of myocardial infarction (MI), and rates of death were among the outcome indicators evaluated.
Results: according to outcome the mean duration of follow-up was 31.23 (±18.27 SD) with range (1-60) months, according to early adverse event there were 1 (0.5%) with cardiac death, 1 (0.5%) with major Ipsilateral Nonfatal Strokes, 2 (1%) with minor strokes, there were 30 cases of cardiac death (15%), 2 cases of neurological death (1%), 4 cases of death for other reasons (2%), 2 cases of major ipsilateral nonfatal stroke (1%), 1 case of major contralateral nonfatal stroke (0.5%), 10 cases of minor ischemic stroke (5%), 12 cases of transient ischemic attack (2%), and 2 cases of nonfatal myocardial infarction (1%).
Conclusion: Patients with concurrent carotid and coronary artery disease may benefit from both hybrid revascularization by CAS-CAB and phased revascularization by CAS-CAB, which are feasible, safe, and provide good short- and long-term results. Our research suggests that CAS should be considered as a feasible alternative to open heart surgery. An adequately powered randomised experiment should compare the two approaches.

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