Long-term results after simultaneous carotid and coronary revascularisation

被引:3
作者
Zivkovic, Igor [1 ]
Krasic, Stasa [2 ]
Milacic, Petar [1 ]
Vukovic, Petar [1 ]
Milicic, Miroslav [1 ]
Jovanovic, Milos [1 ]
Tabakovic, Zoran [1 ]
Sagic, Dragan [3 ]
Ilijevski, Nenad [4 ]
Peric, Miodrag [1 ]
Bojic, Milovan [1 ]
Micovic, Slobodan [1 ]
机构
[1] Dedinje Cardiovasc Inst, Dept Cardiac Surg, Belgrade, Serbia
[2] Mother & Child Hlth Inst Serbia, Cardiol Dept, Belgrade, Serbia
[3] Dedinje Cardiovasc Inst, Dept Intervent Radiol, Belgrade, Serbia
[4] Dedinje Cardiovasc Inst, Dept Vasc Surg, Belgrade, Serbia
关键词
Carotid artery; coronary artery disease; endarterectomy; coronary artery bypass; ARTERY-BYPASS GRAFT; HEART-SURGERY; ENDARTERECTOMY; OUTCOMES; EXPERIENCE;
D O I
10.1177/02184923221124881
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background The revascularisation strategy for concomitant carotid and coronary disease is unknown. Simultaneous or stage coronary artery stenting and carotid endarterectomy are the most common revascularisation approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting or carotid endarterectomy in patients who underwent coronary artery bypass surgery. Methods This is a prospective cohort non-randomised single-institution study. During the period from 2012 to 2015, sixty consecutive patients (65.9 +/- 7.41 mean) underwent simultaneous carotid artery stenting and coronary artery bypass surgery (n = 30) or simultaneous carotid endarterectomy and coronary artery bypass surgery (n = 30). The primary endpoints were short- and long-term rates of adverse events (transient ischemic attack, stroke, myocardial infarction, and death). The mean follow-up was 62.05 +/- 11.12 months. Results In-hospital mortality was insignificantly higher in the carotid endarterectomy, and coronary artery bypass surgery group (6.6% vs. 0%), the rate of stroke and myocardial infarction was similar (13.3% and 0% in the carotid endarterectomy and coronary artery bypass surgery group vs. 6.6% and 3.3% in the carotid artery stenting and coronary artery bypass surgery group, respectively). The intensive care unit readmission was significantly higher in the surgical revascularisation approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusion Comparing two revascularisation strategies is not straightforward due to different anatomical indications for carotid artery stenting and endarterectomy. We consider that each technique has an essential role in carotid revascularisation. Good selection of patients, according to indications, contributes to satisfactory short- and long-term results.
引用
收藏
页码:977 / 984
页数:8
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