| Simultaneous hybrid revascularization by carotid stenting and coronary artery bypass grafting: the SHARP study. | |
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MedLine Citation:
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PMID: 19463460 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 2 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-25 Completed Date: 2010-09-29 Revised Date: 2012-08-29 |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 393-401 Citation Subset: IM |
Affiliation:
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Divisione di Cardiologia, Università Tor Vergata, Rome, Italy. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; 90055-48-4/clopidogrel |
| Comments/Corrections | |
Comment In:
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JACC Cardiovasc Interv. 2009 May;2(5):402-3
[PMID:
19463461
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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