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Chiesa R, Melissano G, Castellano R, et al. Combined carotid endarterectomy and myocardial revascularization: personal experience. Arch Gerontol Geriatr. 1995;20(1):99-104doi: 10.1016/0167-4943(94)00611-a.
Chiesa, R., Melissano, G., Castellano, R., Esposito, G., Donatelli, F., & Grossi, A. (1995). Combined carotid endarterectomy and myocardial revascularization: personal experience. Archives of gerontology and geriatrics, 20(1), 99-104. https://doi.org/10.1016/0167-4943(94)00611-a
Chiesa, R, et al. "Combined carotid endarterectomy and myocardial revascularization: personal experience." Archives of gerontology and geriatrics vol. 20,1 (1995): 99-104. doi: https://doi.org/10.1016/0167-4943(94)00611-a
Chiesa R, Melissano G, Castellano R, Esposito G, Donatelli F, Grossi A. Combined carotid endarterectomy and myocardial revascularization: personal experience. Arch Gerontol Geriatr. 1995 Jan-Feb;20(1):99-104. doi: 10.1016/0167-4943(94)00611-a. PMID: 15374263.
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Arch Gerontol Geriatr. 1995 Jan-Feb;20(1):99-104. doi: 10.1016/0167-4943(94)00611-a.

Combined carotid endarterectomy and myocardial revascularization: personal experience.

Archives of gerontology and geriatrics

R Chiesa, G Melissano, R Castellano, G Esposito, F Donatelli, A Grossi

Affiliations

  1. Institute for Cardiovascular and Respiratory Disease, University of Milan, IRCCS, 11. San Raffaele, Via Olgettina, 60, 1-20131 Milano, Italy.

PMID: 15374263 DOI: 10.1016/0167-4943(94)00611-a

Abstract

A significant percentage of patients undergoing myocardial revascularization suffer from extracranial cerebrovascular disease; recognition of such combined lesions identifies patients at risk for cerebrovascular accidents during the cardiac procedure. Simultaneous or staged coronary artery bypass graft (CABG) and carotid endarterectomy operations have been performed for the last 20 years, however, the clinical indications and the timing of the procedures remain controversial issues. Between November 1988 and January 1994, 1122 patients underwent myocardial revascularization at our Institute and in 35 cases (3.7%) carotid endarterectomy was simultaneously performed; 502 isolated carotid endarterectomies were performed in the same period. Trivascular coronary artery disease was found in 27 cases and low ejection fraction in six. Each patient received an average of 3.7 coronary grafts. Hospital mortality was 5.7% and major neurologic morbidity 2.8%. We believe that a simultaneous approach is recommended in patients with unstable angina and symptomatic carotid artery disease; in patients with a critical but asymptomatic carotid artery stenosis the indication for operation is subject to individual clinical judgment.

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