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Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   March 2019 , Volume 22 , Number 3; Page(s) 132 To 136.
 
Paper: 

Different Strategies in Simultaneous Coronary and Carotid Artery Revascularization – A Single Center Experience

 
 
Author(s):  Zhang Jianbin, Dong Zhiqiang, Liu Peng, Fan Xueqiang, CHEN JIE, Zheng Xia, Ma Bo, Ye Zhidong*
 
* Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, China
 
Abstract: 
Background: The optimal management for patients with concomitant severe coronary artery disease (CAD) and carotid artery stenosis (CAS) remains controversial. We reported our preliminary experience on a synchronous hybrid strategy. Methods: Seven patients with synchronous percutaneous coronary intervention (PCI)/carotid endarterectomy (CEA)/coronary artery bypass grafting (CABG) and 36 patients with synchronous CEA/CABG were enrolled. Then we analyzed the demographics, risk factors and 30-day results of the 2 groups, retrospectively. Results: The 2 groups were comparable in demographics. The operation time was 312. 14 ± 40. 08 minutes for synchronous PCI/CEA/CABG and 294. 58 ± 47. 62 minutes for synchronous CEA/CABG (P = 0. 367). The intraoperative blood loss was 814. 29± 195. 18 mL for synchronous PCI/CEA/CABG and 769. 44 ± 330. 21 mL for synchronous CEA/CABG (P = 0. 731). There was no death in the 2 groups within 30 days. The incidence of primary endpoint [stroke, myocardial infarction (MI) and death] was 14. 29% (1/7) in synchronous PCI/CEA/CABG group and 5. 56% (2/36) in synchronous CEA/CABG group. The difference between the 2 groups was not statistically significant (P = 0. 421). Conclusion: Synchronous PCI, CEA and CABG may be safe and effective in the management of patients with concomitant CAS and complicated multi-vessel CAD. The current data suggested that more studies and randomized controlled trials may be necessary to define whether this strategy is suitable for these patients.
 
Keyword(s): Carotid endarterectomy (CEA),Coronary artery bypass grafting (CABG),Percutaneous coronary angiography (PCI)
 
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