Document Detail


Current concepts on the management of concomitant carotid and coronary disease.
MedLine Citation:
PMID:  23296415     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
In the absence of randomized data, the optimal management of patients with severe carotid and coronary artery disease (CAD), especially those undergoing coronary bypass grafting (CABG), remains unsettled. As a general rule, in patients with multilevel atherosclerotic disease the symptomatic vascular discrict should be treated first. The entirely surgical approach with carotid endarterectomy (CEA) and CABG is associated with high event rates. Therefore, whenever in the work-up prior to cardiac surgery severe carotid disease is identified, the indication for CABG should be reassessed and the feasibility of percutaneous coronary intervention (PCI) as an alternative treatment should be explored. If PCI is not an option, carotid artery stenting (CAS) prior to open heart should be considered if the expertise is available. Although perioperative stroke is multifactorial and the value of revascularization of asymptomatic carotid disease prior to open heart surgery remains controversial, treatment of patients with severe bilateral carotid stenosis appears reasonable for perioperative stroke prevention. The aim of carotid revascularization in patient with unilateral severe carotid stenosis should more long-term stroke prevention than merely perioperative stroke reduction. The main advantage of CAS compared with CEA in patients with advanced CAD is the reduction of perioperative myocardial infarction, an event associated to long term mortality.
Authors:
M Roffi; A Cremonesi
Related Documents :
23843405 - Cerebral venous thrombosis due to cryptogenic organising pneumopathy with antiphospholi...
22929965 - Adaptable pulmonary artery band for late arterial switch procedure in transposition of ...
24667945 - Ethmoidal dural arteriovenous fistula with unusual drainage route treated by transarter...
24431245 - Cerebral arterial angioplasty in a patient with loeys-dietz syndrome.
10986025 - Intraoperative renal duplex sonography: a valuable method for evaluating renal artery r...
19707895 - Redistribution pattern of fetal liver circulation in intrauterine growth restriction.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  54     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  47-54     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University Hospital, Geneva, Switzerland - marco.roffi@hcuge.ch.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Proximal endovascular occlusion for carotid artery stenting.
Next Document:  Carotid stenting in asymptomatic patients: how to identify patients without symptoms and at high ris...