Carotid artery stenting prior to coronary artery bypass grafting in patients with carotid stenosis: Clinical outcomes

Reza Mohammadian, Ali Tarighatnia, Ehsan Sharifipour, Eskandar Nourizadeh, Rezayat Parvizi, Camille T. Applegate, Nader D. Nader (Coresponding Author)

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Objectives: Management of patients undergoing coronary artery bypass grafting (CABG) with obstructive disease of the carotid arteries is still a matter of debate. We compared the results of staged carotid artery stenting (CAS) before CABG in patients with carotid lesions. Materials and Method: Patients with significant carotid artery disease who were deemed to simultaneously suffer from an obstructive coronary artery disease requiring CABG from 2008 to 2018 were screened and enrolled in this study. We performed a staged CAS in cases with ≥60% stenosis and neurological symptoms or asymptomatic patients with ≥80% carotid artery stenosis. Patients with bilateral carotid lesions received sequential CAS within three weeks. Six weeks after the CAS procedure, all patients underwent CABG. Results: A total of 142 patients were included. Eighty-five of these had neurological symptoms, while the remaining 40% were asymptomatic. Thirty-one patients underwent sequential CAS for bilateral lesions. The cerebrovascular event (CVE) following CAS (3 patients) and CABG (3 patients) was 4.2%. There was only a single case of mortality in this cohort. Although it was not statistically significant, CVE after CABG was more frequent in patients with bilateral carotid disease. Conclusions: Our results showed that staged CAS could be performed with minimal adverse outcomes in patients suffering from a simultaneous occlusive disease of carotids and coronary arteries before CABG. Bilateral CAS will further decrease cerebrovascular events and could be performed consequently or concomitantly.

Original languageEnglish
Pages (from-to)30-36
Number of pages7
JournalInterventional Neuroradiology
Volume29
Issue number1
DOIs
Publication statusPublished - Feb 2023
Externally publishedYes

Keywords*

  • Carotid artery stenting
  • coronary artery bypass grafts
  • coronary artery disease
  • stroke

Field of Science*

  • 3.2 Clinical medicine

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

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