Document Detail


Simultaneous hybrid revascularization by carotid stenting and coronary artery bypass grafting: the SHARP study.
MedLine Citation:
PMID:  19463460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In an attempt to reduce post-operative events we investigated a new therapeutic strategy consisting of a simultaneous hybrid revascularization by carotid artery stenting (CAS), immediately followed by an on-pump coronary artery bypass graft (CABG).
BACKGROUND: Preventing stroke and cardiovascular events after coronary artery revascularization in patients with elevated surgical risk is a complex and multifaceted problem.
METHODS: One hundred-one consecutive patients with severe carotid and coronary artery disease and a standard EuroSCORE >or=5 were included in this multicenter study. Immediately after CAS, patients underwent CABG. The primary end point was the incidence of stroke, acute myocardial infarction (AMI), or death at 30 days. Secondary outcomes were transient ischemic attacks; major local complications; bleeding and systemic complications within 30 days after treatment; and any stroke, AMI, or death occurring from the 31st day to the end of the 12-month follow-up. All clinical outcomes were assessed by an independent monitoring board.
RESULTS: The rate of procedural success was 98%. The 30-day cumulative incidence of disabling stroke, AMI, or death was 4%: 2 patients died (2%) in the post-operative period, and 2 patients (2%) had a stroke immediately after CAS and before CABG. Three patients died from the 31st day to the 12th month after the procedure.
CONCLUSIONS: Our findings indicate that in high-risk patients with coronary artery disease suitable for CABG and carotid artery disease, the hybrid revascularization by CAS immediately followed by CABG is a promising and feasible therapeutic strategy.
Authors:
Francesco Versaci; Bernhard Reimers; Costantino Del Giudice; Joachim Schofer; Alessandro Giacomin; Salvatore Saccà; Roberto Gandini; Remo Albiero; Antonio Pellegrino; Fabio Bertoldo; Giovanni Simonetti; Luigi Chiariello
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  2     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-25     Completed Date:  2010-09-29     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-401     Citation Subset:  IM    
Affiliation:
Divisione di Cardiologia, Università Tor Vergata, Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary*
Carotid Arteries*
Carotid Artery Diseases / drug therapy,  therapy*
Coronary Artery Bypass, Off-Pump*
Coronary Artery Disease / pathology*,  surgery
Drug-Eluting Stents*
Female
Humans
Male
Platelet Aggregation Inhibitors / therapeutic use
Prospective Studies
Ticlopidine / analogs & derivatives,  therapeutic use
Time Factors
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel
Comments/Corrections
Comment In:
JACC Cardiovasc Interv. 2009 May;2(5):402-3   [PMID:  19463461 ]

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


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