Comparison of Results of Carotid Stenting Followed by Open Heart Surgery Versus Combined Carotid Endarterectomy and Open Heart Surgery (Coronary Bypass With or Without Another Procedure)

Combined Carotid and Cardiac Surgery: Improving the Results

“…Proposed therapeutic strategies have included simultaneous CEA-CABG, staged or reverse staged procedures, performing only CABG, carotid artery stenting (CAS) before CABG, and the use of off-pump CABG. [8][9][10] However, despite multiple studies, there remain no generally accepted guidelines for the optimal therapeutic approach to adopt in this subgroup of patients.…”

Treatment Strategy for Combined Carotid Artery Stenosis and Coronary Artery Disease: Staged or Simultaneous Surgical Procedure?

“…Totally 41,901 patients undergoing simultaneous or staged carotid and coronary procedures were collected from 53 reports (Evagelopoulos et al 2000;Snider et al 2000;Minami et al 2000;Gaudino et al 2001;Hamulu et al 2001;Youssuf et al 2001;Estes et al 2001;Farooq et al 2001;Bonacchi et al 2002;Bonardelli et al 2002;Antunes et al 2002;Zacharias et al 2002;Meharwal et al 2002;Roddy et al 2002;Char et al 2002;Beauford et al 2003;Brown et al 2003;Vitali et al 2003;Ricotta et al 2003;Srimahachota et al 2004;Mishra et al 2004;Ricotta et al 2005;Ziada et al 2005;Cinar et al 2005;Eren et al 2005;Chiappini et al 2005;Akins et al 2005;Nwakanma et al 2006;Inciura and Benetis 2006;Kolh et al 2006;Byrne et al 2006;Cywinski et al 2006;Kovacic et al 2006;Mendiz et al 2006;Randall et al 2006;Chiariello et al 2006;Hertzer and Mascha 2006;Madi-Jebara et al 2006;Kougias et al 2007;Dubinsky and Lai 2007;…”

The Brain First or the Heart: The Approach to Revascularizing Severe Co‐Existing Carotid and Coronary Artery Disease

“…17 The patients that underwent CAS and CABG had more CAD, angina, symptomatic carotid disease, renal impairment, and diabetes as compared to the high risk patients enrolled in the SAPPHIRE trial. 17 However, this study could be faulted for being small, retrospective, and nonrandomized, and CAS followed by staged CABG was not compared to staged CABG prior to CAS or to staged CEA and CABG.…”

“…Using a logistic regression model that accounted for baseline differences, CAS, and CABG resulted in less MI, CVA, and death, although the differences were not statistically significant. 17 Despite the fact that CAS was performed in patients with a greater number of co-morbidities such as depressed LV function, CAS followed by CABG was associated with markedly less adverse events than hybrid surgical revascularization. 17 The patients that underwent CAS and CABG had more CAD, angina, symptomatic carotid disease, renal impairment, and diabetes as compared to the high risk patients enrolled in the SAPPHIRE trial.…”

“…17 Despite the fact that CAS was performed in patients with a greater number of co-morbidities such as depressed LV function, CAS followed by CABG was associated with markedly less adverse events than hybrid surgical revascularization. 17 The patients that underwent CAS and CABG had more CAD, angina, symptomatic carotid disease, renal impairment, and diabetes as compared to the high risk patients enrolled in the SAPPHIRE trial. 17 However, this study could be faulted for being small, retrospective, and nonrandomized, and CAS followed by staged CABG was not compared to staged CABG prior to CAS or to staged CEA and CABG.…”