Document Detail


Non-protected carotid artery stent without angioplasty in high-risk patients with carotid and coronary artery disease undergoing cardiac surgery.
MedLine Citation:
PMID:  20151852     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemodynamic depression (HD) is a frequent complication related to carotid endartherectomy or carotid artery stenting (CAS), often not well tolerated in patients with coronary artery disease. The purpose of this study is to assess whether CAS without angioplasty is beneficial in patients with severe carotid artery disease before coronary revascularization surgery (CABG) regarding the occurrence of HD. Between October 2002 and August 2006, 39 CAS were performed in 35 patients before cardiac surgery. Outcome measures, including periprocedural and 30-day post stenting and cardiac surgery complications, were assessed. Twenty-seven patients underwent CABG and eight combined CABG and valve replacement. During or immediately after CAS there was no episode of bradycardia or hypotension necessitating medical treatment. In the period between CAS-CABG, there was no case of HD. We also found no myocardial infarction. There were five neurological complications, two of them in the period between CAS-CABG (one transitory ischemic attack (TIA) and one minor stroke) and three after CABG (one TIA and two strokes). Three of them were discharged symptom-free. CAS without angioplasty can be a safe alternative to treat patients with coexistence of carotid and cardiac disease, since does not produce hemodynamic depression, therefore diminishing the cardiac complications.
Authors:
Martin Rabellino; Luis Garcia-Nielsen; Sebastian Baldi; Tobias Zander; Carmen Casasola; Arnaldo Estigarribia; Rafael Llorens; Manuel Maynar
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy     Volume:  19     ISSN:  1365-2931     ISO Abbreviation:  Minim Invasive Ther Allied Technol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612996     Medline TA:  Minim Invasive Ther Allied Technol     Country:  England    
Other Details:
Languages:  eng     Pagination:  184-8     Citation Subset:  IM    
Affiliation:
Department of Endovascular therapy, Hospital Hospiten, Santa Cruz de Tenerife, Spain. jmrabellino@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon
Bradycardia / etiology
Carotid Arteries / pathology*
Carotid Artery Diseases / surgery*
Coronary Artery Disease / surgery*
Endarterectomy, Carotid / adverse effects*
Female
Hemodynamics
Humans
Hypotension / etiology
Male
Middle Aged
Preoperative Care
Prospective Studies
Risk Factors
Stents / adverse effects*
Time Factors

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


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