Management of Combined Severe Carotid and Coronary Artery Disease

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2012 Jan 25

PMID 22270260

Citations 8

Authors

Marco Roffi

Flavio Ribichini

Fausto Castriota

Alberto Cremonesi

Affiliations

Soon will be listed here.

Abstract

Patients with severe carotid and coronary disease-especially if they require coronary artery bypass grafting (CABG)-are at high risk of cardiac events and stroke. Carotid revascularization should be considered for patients with symptomatic carotid disease and bilateral severe asymptomatic carotid stenosis. In patients with unilateral asymptomatic carotid stenosis, decision to proceed to revascularization should be based more on a perspective of long-term stroke prevention than of perioperative stroke reduction. Compared with endarterectomy, carotid artery stenting is associated with a lower incidence of periprocedural myocardial infarction, an event linked to long-term mortality. This observation may be particularly relevant for patients with advanced coronary artery disease such as those undergoing CABG. Irrespective of the carotid revascularization strategy, a broad disease management approach based on lifestyle modification and pharmacologic cardiovascular prevention is more likely to affect both the quality and duration of life than revascularization itself.

Citing Articles

Long-Term Outcomes of Coronary and Carotid Artery Disease Revascularization in the FRIENDS Study.

Tomai F, Piccoli A, Castriota F, Weltert L, Reimers B, Pesarini G J Interv Cardiol. 2019; 2019:8586927.

PMID: 31772548 PMC: 6739755. DOI: 10.1155/2019/8586927.

Prevalence of Carotid Stenosis and Incidence of Ischemic Stroke in Patients Undergoing Non-Coronary Cardiac Surgery.

Costa M, Nadal J, Okamoto J, Betero A, Schafranski M, Gomes R Braz J Cardiovasc Surg. 2019; 34(5):550-559.

PMID: 31112018 PMC: 6852460. DOI: 10.21470/1678-9741-2018-0127.

Prevalence of extracranial carotid atherosclerosis in the patients with coronary artery disease in a tertiary hospital in Malaysia.

Sahadevan M, Chee K, Tai M Medicine (Baltimore). 2019; 98(15):e15082.

PMID: 30985661 PMC: 6485885. DOI: 10.1097/MD.0000000000015082.

Prevalence of carotid artery stenosis in ischaemic heart disease patients in Bangladesh.

Adhikary D, Ranjan R, Mandal S, Hawlader M, Mitra D, Adhikary A SAGE Open Med. 2019; 7:2050312119830838.

PMID: 30800301 PMC: 6378417. DOI: 10.1177/2050312119830838.

Risk factors for perioperative ischemic stroke in cardiac surgery.

Costa M, Gauer M, Gomes R, Schafranski M Rev Bras Cir Cardiovasc. 2015; 30(3):365-72.

PMID: 26313728 PMC: 4541784. DOI: 10.5935/1678-9741.20150032.

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