Efficacy of simultaneous carotid artery stenting and coronary artery bypass grafting for carotid stenosis and concomitant coronary disease
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R654.3

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    Abstract:

    Objective: To evaluate the efficacy of simultaneous carotid artery stenting (CAS) and coronary artery bypass grafting (CABG) in treatment of carotid stenosis and concomitant coronary disease. Methods: The clinical data of 25 patients with carotid stenosis and concomitant coronary disease treated in China-Japan Friendship Hospital from January 2007 to December 2014 were retrospectively analyzed. Of the patients, 11 cases underwent simultaneous CAS and CABG (one-stage group), and 14 cases underwent staged CAS and CABG (two-stage group). The main clinical variables between the two groups of patients were compared. Results: The preoperative general data were comparable between the two groups. In one-stage group compared with two-stage group, the median operative time (250 min vs. 280 min) and median length of hospital stay (19 d vs. 24 d) were significantly reduced (both P<0.05), while the median intraoperative blood loss (750 mL vs. 600 mL), blood infusion (1 000 mL vs. 1 200 mL), length of ICU stay (23 h vs. 24 h) and time on ventilator (19 h vs. 16.5 h) all showed no statistical difference (all P>0.05). Minor stroke within 30 d after operation, transient ischemia attack and perioperative pulmonary infection occurred in one case each and transient postoperative hypotension occurred in 3 cases in one-stage group; TIA occurred in one case, transient postoperative hypotension occurred in 4 cases, re-thoracotomy for hemostasis was required in one case and perioperative pulmonary infection occurred in one case in two-stage group. No myocardial infarction or death occurred in either of the groups. Conclusion: Both simultaneous and staged CAS and CABG are safe and reliable in treatment of carotid stenosis concomitant with coronary disease, and the simultaneous procedure can reduce operative time and hospitalization. However, the appropriate treatment method should be chosen according to the patients’ characteristics.

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张建彬,樊雪强,郑夏,陈洁,马博,孔杰,崔艺耀,王峰,聂强强,叶志东,刘鹏. Efficacy of simultaneous carotid artery stenting and coronary artery bypass grafting for carotid stenosis and concomitant coronary disease[J]. Chin J Gen Surg,2017,26(6):711-716.
DOI:10.3978/j. issn.1005-6947.2017.06.007

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History
  • Received:October 14,2016
  • Revised:May 07,2017
  • Adopted:
  • Online: June 15,2017
  • Published: