| Treatment strategy for combined carotid artery stenosis and coronary artery disease: staged or simultaneous surgical procedure? | |
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MedLine Citation:
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PMID: 19851053 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients with combined carotid and coronary arterial diseases pose a high risk of cerebrovascular events, and the treatment of choice with either a simultaneous or a staged surgical procedure remains controversial. The literature of combined carotid and coronary arterial diseases of a recent decade in English was retrieved. Totally 41,901 patients undergoing simultaneous or staged carotid and coronary procedures from 53 reports were included. As a result, carotid endarterectomy plus coronary artery bypass remained the most commonly used procedure for the intervention of combined carotid artery stenosis and coronary artery disease, and was associated with higher incidences of perioperative transient ischemic attack, stroke and hospital mortality, but with less perioperative myocardial infarction comparing with the staged procedures. Patients with a simultaneous carotid endarterectomy and coronary artery bypass were generally related more to an advanced atherosclerotic coronary artery disease, so that a pure comparison between the two strategies was not always possible. To compare the efficacy of different surgical methods for combined carotid and coronary arterial diseases is of pronounced importance. The new hybrid approach consisting of the simultaneous carotid artery stenting and subsequent on-pump coronary artery bypass can be a safe approach, with the aim to reduce the surgical trauma as compared to surgical procedures, and to reduce the risk of myocardial infarction in the interval period required for the staged operations. Thus, for patients with combined carotid artery stenosis and coronary artery disease, the simultaneous surgical procedure, rather than the staged procedure, is recommended. |
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Authors:
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Shi-Min Yuan; Hai-Wei Wu; Hua Jing |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Tohoku journal of experimental medicine Volume: 219 ISSN: 1349-3329 ISO Abbreviation: Tohoku J. Exp. Med. Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-10-23 Completed Date: 2010-02-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417355 Medline TA: Tohoku J Exp Med Country: Japan |
Other Details:
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Languages: eng Pagination: 243-50 Citation Subset: IM |
Affiliation:
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Department of Cardiothoracic Surgery, Jinling Hospital, School of Clinical Medicine, Nanjing University, Nanjing, Jiangsu Province, People's Republic of China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carotid Stenosis / complications*, mortality, surgery* Coronary Artery Disease / complications*, mortality, surgery* Demography Female Hospitals Humans Male Regression Analysis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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