Simultaneous carotid endarterectomy and coronary bypass: Perioperative risk and long-term survival

Abstract

Selection criteria for CABG-CEA greatly influence perioperative risk. Despite the greater age and more advanced coronary artery disease in the CABG-CEA group, long-term outcome differences are accounted for entirely by differences in perioperative morbidity and mortality. Prospective trials of strategies such as staged CEA and CABG to reduce perioperative risk are needed.

Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

“…The degree of carotid lesion was also studied. Thus, is some studies, mean stenosis exceeded 85% 18,26 . Signifi cant bilateral lesion was present in up to 60% to 90% of the cases 14,16 .…”

“…Moreover, permanent stroke was previously diagnosed in about 20% of the patients in some series 16,18,26,27 . The degree of carotid lesion was also studied.…”

“…Nevertheless, cutoff point for establishing signifi cant lesion ranges from 70% to 80% 1,8,18 . Other indications, such as bilateral lesion ≥ 50%, unilateral lesion ≥ 50% with the other side occluded and presence of carotid bruit, are also taken into account by other authors 9,13,15,16,18,19,26,34,35 .…”

“…In some series, CABG was preceded by CE under the same anesthesia without extracorporeal circulation (ECC) 7,9,12,17,26,36 . Still, Khaitan et al 13 have reported good results with the combined procedure using ECC.…”

“…Risk of perioperative stroke increases nearly three-fold in patients with history of cerebrovascular ischemia 31 . With the combined approach, these rates drop to around 10% for neurological lesions 26,27,[39][40][41][42][43][44] . Other major risk factors for neurological damage following CABG include advanced age and prolonged ECC time 45 .…”