Surgical Treatment of Patients With Combined Atherosclerotic Disease of Carotid and Coronary Arteries

Horev, Nechama; Ermolin, P.A.; Соколов, А В; Kosouhov, A.P.; Duda, Anna; Kon'kova, V O; Shojhet, Ya.N.; Dispensary, Altai Regional Cardiological

doi:10.31684/2541-8475.2018.1(9).61-67

Cited by 4 publications

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“…Пациенты с МФА, требующие реваскуляризации каротидного и коронарного сосудистых бассейнов, тяжелее пациентов с возможностью изолированного проведения КЭЭ. Частота ишемических неврологических осложнений у больных с МФА при одномоментном или этапном КШ и КЭЭ выше, чем при изолированной КЭЭ [21].…”

Section: передовая статья обзор литературыunclassified

Selection of optimal revascularization tactics in patients with polyvascular disease: a literature review

Gaigiev,

Kostanyan,

Nikolaev

2024

Russ J Cardiol

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Patients with polyvascular disease (PVD), involving two or more vascular beds, are a difficult group for cardiologists, cardiovascular surgeons and endovascular surgeons. The relevance of the problem is due to its widespread prevalence, rapid progression, and comorbidity, which worsens the prognosis in this cohort of patients. The problem of selecting the optimal revascularization tactics remains unresolved. The results of original research on this problem are analyzed. The need for an individual multidisciplinary approach to determine the best revascularization strategy is demonstrated. The use of various methods of optimal therapy, open and endovascular surgery in each specific case is the most acceptable tactic.

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Section: передовая статья обзор литературыunclassified

Selection of optimal revascularization tactics in patients with polyvascular disease: a literature review

Gaigiev,

Kostanyan,

Nikolaev

2024

Russ J Cardiol

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Factors affecting the availability of hybrid cerebral and myocardial revascularization

Tarasov

Данилович

2023

Cardiovasc Ther Prev

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Aim. To analyze factors affecting the availability of hybrid cerebral and myocardial revascularization by synchronous percutaneous coronary intervention (PCI) and carotid endarterectomy (CEA).Material and methods. This retrospective study included 263 patients with coronary and internal carotid artery involvement undergoing PCI and CEA during the period from 2011 to 2017.Results. The study revealed the following factors increasing the availability of revascularization: hybrid cerebral and myocardial revascularization, successful PCI using drug-eluting stents, postPCI TIMI flow grade 3, and radial access for PCI. The following factors reduced the availability: polyvascular disease >50% in three beds, prior PCI, left ventricular ejection fraction <50%, left coronary artery involvement, living without a family, staged revascularization, CEA before PCI, unsuccessful/complicated PCI with post-PCI TIMI flow grades of 0-1, residual SYNTAX score >9, emergency hospitalization and multiple emergency PCI of the coronary arteries in the long-term follow-up period.Conclusion. Comprehensive analysis of clinical, demographic, anatomical, angiographic, and perioperative factors made it possible to identify predictors that affect the availability of hybrid revascularization.

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Comparative Evaluation of Results of Carotid Artery Stenting and Carotid Endarterectomy in Patients With High Surgical Risk

SULTANOV¹,

CHIGOGIDZE²,

SULTANOV³

et al. 2023

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ents with high surgical risk. Methods: 84 patients with combined lesions of carotid bifurcations and coronary arteries were examined. There were 55 men (65.6%), and 29 women (34.4%) aged 42-84 years (median age 64 years). Various comorbidities were identified in 52 (61.9%) patients. Patients were divided into two groups: those who underwent CAS (35) and CEA (49). The follow-up period after surgery was up to 30 days (early), and up to 8 years (long-term). A comparative assessment of perioperative complications and long-term results after CAS and CEA were carried out. Results: The identified cerebrovascular risk factors for the development of perioperative complications were identical in both groups: recent stroke, occlusion of the contralateral internal carotid artery (ICA), intracranial lesions, and anomalies of the circle of Willis. Other risks included psychoemotional stress (85%), risk of nerve damage, bleeding, angina III, and IV functional classes (53.5%). Although not statistically significant, noticeable differences were found in perioperative complications after CAS and CEA (14.3% vs. 28.6%, respectively, p>0.05). In the long term, there were no statistically significant differences between the CAS and CEA groups in terms of overall survival (97.2% versus 100%, respectively, p>0.05), transient ischemic attacks (2.8% versus 4.1%, respectively, p>0.05), development of non-fatal myocardial infarction (MI) (11.4% versus 12.2%, respectively, p>0.05), fatal MI (2.8% versus 0%, respectively). Conclusion: Analysis of the immediate results of CAS and CEA showed, although statistically insignificant, noticeable advantages of the first method in the overall frequency of perioperative complications (14.3% vs. 28.6%, p>0.05) in patients from the category of high surgical risk. According to the main criteria of long-term results of the two methods, there was also no statistically significant difference, which allowed us to consider the endovascular method of treatment as an alternative to the traditional surgical technique. Keywords: Carotid artery stenting, carotid endarterectomy, high surgical risk, complications.

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Surgical Treatment of Patients With Combined Atherosclerotic Disease of Carotid and Coronary Arteries

Cited by 4 publications

References 0 publications

Selection of optimal revascularization tactics in patients with polyvascular disease: a literature review

Selection of optimal revascularization tactics in patients with polyvascular disease: a literature review

Factors affecting the availability of hybrid cerebral and myocardial revascularization

Comparative Evaluation of Results of Carotid Artery Stenting and Carotid Endarterectomy in Patients With High Surgical Risk

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