Management of coexisting coronary artery and asymptomatic carotid artery disease: report of a series of patients treated with coronary bypass alone.
BACKGROUND
A retrospective chart review of 94 patients with asymptomatic high-grade carotid stenosis undergoing coronary bypass (and valve replacement in some cases) was performed to determine whether significant carotid lesions can be safely ignored in patients undergoing cardiac surgical procedures. These operations were performed during a 2-year period.


METHODS
There were 55 men and 39 women, with an age range of 37-89 years. Seventy-one patients had unilateral high-grade carotid stenosis, 17 patients had bilateral high-grade lesions, and six patients had unilateral high-grade stenosis and contralateral occlusion. Associated medical problems were recorded and short-term follow-up was obtained.


RESULTS
There was one perioperative stroke and no deaths in this group of patients.


CONCLUSIONS
Although these data indicate that high-grade carotid stenoses may be safely ignored during cardiac surgical procedures, a multicentre prospective randomized trial is needed to determine the appropriate treatment of the patient with coexisting carotid and coronary artery disease.
Safa
T K
TK
Division of Vascular Surgery, North Shore University Hospital, Manhasset, NY 11030, USA.
Friedman
S
S
Mehta
M
M
Rahmani
O
O
Scher
L
L
Pogo
G
G
Hall
M
M
D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography