Management of coexistent carotid artery and coronary artery disease

At the present time staged carotid reconstruction several days before elective coronary artery bypass surgery seems to be the safest and most logical approach for patients with neurological symptoms, stable cardiac symptoms, and acceptable coronary anatomy. Combined procedures may well be necessary...

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Bibliographic Details
Published in:Stroke (1970) 1988-11, Vol.19 (11), p.1441-1444
Main Authors: GRAOR, R. A, HETZER, N. R
Format: Article
Language:English
Subjects:
Angiocardiography
Arteriosclerosis - complications
Atherosclerosis (general aspects, experimental research)
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Carotid Artery Diseases - complications
Carotid Artery Diseases - diagnostic imaging
Carotid Artery Diseases - surgery
Cerebral Angiography
Cerebrovascular Disorders - etiology
Coronary Artery Bypass - adverse effects
Coronary Disease - complications
Coronary Disease - diagnosis
Coronary Disease - surgery
Electrocardiography
Endarterectomy - adverse effects
Endarterectomy - methods
Exercise Test
Heart - diagnostic imaging
Humans
Medical sciences
Nervous System Diseases - etiology
Postoperative Period
Radionuclide Imaging
Risk Factors
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Summary:At the present time staged carotid reconstruction several days before elective coronary artery bypass surgery seems to be the safest and most logical approach for patients with neurological symptoms, stable cardiac symptoms, and acceptable coronary anatomy. Combined procedures may well be necessary for those who have active neurological symptoms or bilateral carotid lesions in conjunction with diffuse or unstable coronary artery disease, but the incidence of neurological complications at the time of simultaneous operations could exceed the stroke risk for either carotid endarterectomy or coronary bypass alone. The asymptomatic patient with unilateral carotid stenosis who presents for coronary artery bypass might be best managed by myocardial revascularization followed by medical or surgical management of the carotid disease. In order to obtain optimal long-term results, both coronary disease and associated carotid disease require appropriate evaluation and medical and surgical management.
ISSN:0039-2499
1524-4628
DOI:10.1161/01.str.19.11.1441