The impact of coronary artery disease on carotid endarterectomy

• Published in: Annals of surgery 1983-12, Vol.198 (6), p.705-712
• Main Authors: O'DONNELL, T. F. JR, CALLOW, A. D, WILLET, C, PAYNE, D, CLEVELAND, R. J
• Format: Article
• Language: English
• Subjects: Arteriosclerosis - mortality; Arteriosclerosis - surgery; Biological and medical sciences; Carotid Arteries - surgery; Cerebrovascular Disorders - etiology; Coronary Artery Bypass; Coronary Disease - mortality; Coronary Disease - surgery; Endarterectomy - adverse effects; Endarterectomy - mortality; Humans; Medical sciences; Myocardial Infarction - etiology; Myocardial Infarction - mortality; Neurology; Prognosis; Risk; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0003-4932; 1528-1140
• DOI: 10.1097/00000658-198312000-00007

In a series of 531 CENDX, preoperative cardiac risk was categorized by clinical criteria. Patients with CAD (history of previous MI, angina, congestive heart failure, and/or electrocardiographic evidence of CAD were selected for more invasive studies based on clinical criteria. The overall incidence of postoperative myocardial infarction was 2.5% and increased slightly to 4% in patients with symptomatic cardiac disease. More importantly, the overall mortality was 0.9% and only 3 of 13 (23%) postoperative myocardial infarctions were fatal. Neurologic complications averaged 1.4% and approximately 70% were related to preceding cardiac events. Twenty-two patients or 4% of the entire series underwent carotid endarterectomy combined with coronary artery bypass graft and this approach was associated with one death and one stroke. Therefore, we conclude that a selective approach to coronary arteriography and subsequent CABG based on clinical criteria is associated with an acceptably low mortality and cardiac morbidity.