Twenty-Four Hour Staged Carotid Endarterectomy Followed by Off-Pump Coronary Bypass Grafting for Patients With Concomitant Carotid and Coronary Disease

Nabagiez, John P.; Bowman, Kimberly; Shariff, Masood A.; Abreu, Juan; Singh, Anurag K.; Waagner, Wolf von; Khan, Muhammad Arif; Singh, Kuldeep; McGinn, Joseph T.

doi:10.1016/j.athoracsur.2014.05.069

Cited by 8 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This probably leads back to their shorter interstage time (1.8 ± 5.6 days versus 8.3±7.9 days, in our study). While the interstage time in our study cohort often exceeded 7 days, 89% of the patients in the study of Nabagiez et al [Nabagiez 2014] received the CABG surgery within 24 hours after CEA, suggesting that a short interstage time correlates with a lower rate of interstage MIs.…”

Section: Discussionmentioning

confidence: 64%

“…Over the last decades there has been an ongoing controversy about the optimal treatment strategy for concurrent CAD and carotid artery stenosis [Poi 2018;Borger 1999;Van der Heyden 2008]. There are studies supporting the synchronous approach [Shishehbor 2013;Gopaldas 2011], while others indicate that the staged one can be performed safely [Nabagiez 2014;Antunes 2002]. Again, others say that there is no difference, when both strategies are compared [Iyem 2009;Naylor 2003].…”

Section: Discussionmentioning

confidence: 99%

“…Staged procedure: In a retrospective study, Nabagiez et al [Nabagiez 2014] analyzed the outcomes of 90 patients receiving staged CEA plus CABG. They showed IS and TIA rate of 1% each, which is comparable to our results.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Synchronous or Staged Carotid Endarterectomy and Coronary Artery Bypass Grafting? Propensity score matched study

Hempe

Moza

Goetzenich

et al. 2018

HSF

View full text Add to dashboard Cite

Background: The optimal treatment strategy in patients presenting with hemodynamically significant carotid artery disease who are to undergo cardiac surgery, remains controversial. In this study, we retrospectively analyzed the outcome data of patients receiving synchronous or staged coronary artery bypass graft (CABG) surgery and carotid endarterectomy (CEA). Methods: Between 2011 and 2016, 3173 patients underwent CABG surgery in our institution, of whom 323 received CABG and CEA either as synchronous (N = 307) or as staged (N = 16) procedures. Patients´ characteristics, peri- and postoperative data were collected from our digital medical database. Propensity score matching was used to match each patient from the staged group to two appropriate patients (1:2 matching) from the synchronous group (synchronousmatched). Results: The overall incidence of ischemic stroke (IS) and transitory ischemic attack (TIA) was 4.9% and 5.6%, respectively. No hemorrhagic stroke was noted in both groups. Incidence of IS did not differ significantly between matched groups (P = 1.000). Significantly higher rates of postoperative neurological complications, such as TIA and delirium, were found in the synchronousmatched group (P = .041 and P = .043, respectively) compared with the staged group. Additionally, there were more postoperative respiratory insufficiencies in the synchronousmatched group (P = .043). Thirty days mortality did not differ significantly between the matched groups. Conclusion: In this experience combined with the data given in literature, our findings suggest a possible superiority of the staged CABG/CEA approach. Large, randomized studies are required to verify our findings and to establish applicable guidelines.

show abstract

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Synchronous or Staged Carotid Endarterectomy and Coronary Artery Bypass Grafting? Propensity score matched study

Hempe

Moza

Goetzenich

et al. 2018

HSF

View full text Add to dashboard Cite

show abstract

“…In the literature, reported rate of mortality is between 0-4.5% and rate of stroke is between 0-3.1% for combined CEA and off-pump CABG (34)(35)(36)(37)(38)(39) . Eren et al (35) reported no stroke and 3.7% mortality for patients who had CEA and simultaneous off-pump CABG.…”

Section: What Are the Surgical Options For Cea; Synchronous Or Stagedmentioning

confidence: 99%

“…Eren et al (35) reported no stroke and 3.7% mortality for patients who had CEA and simultaneous off-pump CABG. Nabagiez et al (36) suggested that twenty-four hour staged CEA followed by off-pump CABG minimizes post-CEA myocardial infarction while minimizing cerebrovascular accident post-CABG in patients with concomitant severe coronary and carotid artery disease. In order to comparison of early outcomes with three different approaches for combined CEA-CABG, Dönmez et al (37) reported that no any further benefit with off-pump technique compared to onpump technique, except for shorter intensive care unit and hospitalization times.…”

Section: What Are the Surgical Options For Cea; Synchronous Or Stagedmentioning

confidence: 99%

How Can We Treat Asymptomatic Carotid Disease in Patients with a Planned CABG?

Kutay¹

2019

ejcm

View full text Add to dashboard Cite

Carotid artery intervention to the neurological asymptomatic patients is one of the most controversial issues of vascular surgery throughout the last decades. The decision about how to manage asymptomatic carotid disease in the setting of planned coronary artery bypass graft (CABG) becomes more complex due to surgical treatment of either pathology may be complicated by multiple factors. Current guidelines do not support routine screening for carotid artery stenosis before CABG because of given the low prevalence of stroke after CABG. Optimal surgical intervention and timing for patients having concomitant severe carotid and coronary artery stenosis remains uncertain. In this brief review, we analyze the incidence of significant carotid stenosis in patients undergoing CABG, association of untreated asymptomatic carotid stenosis on postoperative stroke, effects of carotid endarterectomy (CEA) on postoperative incidence of stroke, determination of surgical options and technical variations for CEA, scanning methods for identifying the vulnerable carotid plaque and revealing risk factors and predictors associated with stroke after CABG. Synchronous or staged CEA still remain valuable options in order to diminish postoperative risk of stroke for neurologically asymptomatic patients undergoing to CABG who have bilateral significant carotid artery stenosis or contralateral occlusion.

show abstract

Invited Commentary

Livesay¹

2014

The Annals of Thoracic Surgery

View full text Add to dashboard Cite

Twenty-Four Hour Staged Carotid Endarterectomy Followed by Off-Pump Coronary Bypass Grafting for Patients With Concomitant Carotid and Coronary Disease

Cited by 8 publications

References 34 publications

Synchronous or Staged Carotid Endarterectomy and Coronary Artery Bypass Grafting? Propensity score matched study

Synchronous or Staged Carotid Endarterectomy and Coronary Artery Bypass Grafting? Propensity score matched study

How Can We Treat Asymptomatic Carotid Disease in Patients with a Planned CABG?

Invited Commentary

Contact Info

Product

Resources

About