Purpose Of Review: The purpose of this review is to evaluate the current indications and results of treatment of combined coronary and carotid disease. Synchronous carotid stenosis in patients with coronary artery disease poses a management challenge in patients with advanced atherosclerosis.
Recent Findings: Recent case series continue to demonstrate concomitant coronary and carotid disease with significant carotid stenosis greater than 70% in approximately 8% of patients evaluated for coronary artery bypass grafting. Surgical management options include staged operations addressing the carotid stenosis first, reverse staged operations addressing the coronary disease first, and combined synchronous operations addressing both territories during the same anesthetic. Recent reports demonstrate safety and acceptable risks with each operative approach. Lower trends in stroke rates were noted following staged procedures when compared with combined procedures. However, several metaanalyses showed no significant difference in rates of combined morbidity and mortality for all three strategies. Total morbidity and mortality risks for combined disease tended to be higher than for isolated coronary artery bypass grafting or carotid endarterectomy procedures performed for disease in a single vascular territory.
Summary: Despite a large volume of data present in the literature, the treatment indications and surgical options remain controversial. We currently advocate treatment of symptomatic territory first in favor of staged procedures and reserve combined procedures for patients with critical stenosis or symptoms in both territories.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/00001573-200311000-00005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Case report: Detecting giant cell arteritis in [Ga]Ga-DOTA-Siglec-9-PET/CT.
Front Immunol
January 2025
Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Bonn, Germany.
Objectives: This study aimed to evaluate the diagnostic utility of [Ga]Ga-DOTA-Siglec-9 positron emission tomography-computed tomography (PET/CT) in assessing disease activity in a patient experiencing a relapse of giant cell arteritis (GCA).
Case Presentation: A 90-year-old male patient with GCA, diagnosed in 2018, was enrolled. Demographic data, disease history, and laboratory parameters, including soluble VAP-1 (sVAP-1) levels, were recorded.
Deep Learning Analysis of White Matter Hyperintensity and its Association with Comprehensive Vascular Factors in Two Large General Populations.
J Imaging Inform Med
January 2025
Department of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Seoul, 05505, Republic of Korea.
Although the relationships between basic clinical parameters and white matter hyperintensity (WMH) have been studied, the associations between vascular factors and WMH volume in general populations remain unclear. We investigated the associations between clinical parameters including comprehensive vascular factors and WMH in two large general populations. This retrospective, cross-sectional study involved two populations: individuals who underwent general health examinations at the Asan Medical Center (AMC) and participants from a regional cohort, the Korean Genome and Epidemiology Study (KoGES).
View Article and Find Full Text PDFCarotid Body Tumor: Incidental Discovery and Diagnosis.
Cureus
December 2024
Internal Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Carotid body tumors (CBTs), rare neuroendocrine neoplasms near the carotid bifurcation, are mostly asymptomatic but may cause discomfort and autonomic dysfunction. Computed tomography angiography (CTA) is used for diagnosis, eliminating the need for a biopsy to avoid the risk of hemorrhage. Surgical excision is the preferred treatment, while radiotherapy is an option when surgery is impractical.
View Article and Find Full Text PDFLeft Atrial Enlargement in Primary Cryptogenic Strokes Without Atrial Fibrillation.
Cureus
December 2024
Cardiovascular Disease, HCA Houston Healthcare, Kingwood, USA.
The relationship between left atrial enlargement (LAE) and primary cryptogenic stroke (PCS) remains a mystery. LAE has been proposed to be an independent risk factor of PCS, recurrent ischemic strokes, paroxysmal atrial fibrillation, and thromboembolism. Our study evaluates the prevalence of LAE among patients with PCS in the absence of atrial fibrillation, unlike previous studies that included atrial fibrillation, in order to isolate LAE as a risk factor.
View Article and Find Full Text PDFTwo types of arteriopathies, arteriomegaly and aneurysms, frequently develop at diverse locations in vertebrobasilar dolichoectasia patients: A retrospective analysis and a meta-analysis.
J Clin Neurosci
January 2025
Department of Neurovascular Research, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan; Department of Neurosurgery, Seijinkai Shimizu Hospital, 11-2 Yamadanakayoshimicho, Nishikyo-ku, Kyoto, Japan.
Background: Past studies have reported that vertebrobasilar dolichoectasia (VBD) patients may develop similar arteriopathies other than the vertebrobasilar system. However, the details of these VBD-related arteriopathies are still unclear.
Methods: We retrospectively enrolled patients diagnosed with VBD at two stroke centers in Japan between January 2012 and December 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!