[Two successful cases of coronary artery bypass grafting followed by transluminal carotid angioplasty with stenting].
In coronary artery bypass grafting (CABG), carotid artery disease is an important factor that affects the incidence of perioperative stroke. The incidence of stroke following cardiac surgery is about 5 times higher in patients with carotid lesions than in patients without them. However, therapeutic strategies for those cases have not established in recent years. We report 2 successful cases of CABG following transluminal carotid angioplasty with stenting (TCAS) for concomitant coronary and carotid artery disease. The first case was a 71-year-old male who had left main trunk (LMT) and three-vessel coronary artery disease (CAD) and a 90% stenosis of the right internal carotid artery (ICA). One month after TCAS, triple CABG with cardiopulmonary bypass (CPB) was performed. The second case was a 75-year-old male who had LMT and single vessel CAD and a 99.9% stenosis of the lt. ICA. Considering his poor general conditions, combined strategy of off-pump CABG and PTCA was performed following TCAS. During and after cardiac surgery, they had no cerebral complications. Postoperative myocardial scintigraphy showed improved imaging in both cases. Preoperative TCAS is a safe and minimally invasive procedure for the patients with carotid artery stenosis who need CABG.
Matsuo
T
T
Department of Cardiovascular Surgery, Kyoto University School of Medicine, Kyoto, Japan.
Nishina
T
T
Masumoto
H
H
Tanbara
K
K
Ueyama
K
K
Fujioka
Y
Y
Hanyu
M
M
Ikeda
T
T
Nishimura
K
K
Komeda
M
M
D000368:Aged; D000800:Angioplasty, Balloon; D002315:Cardiopulmonary Bypass; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000150:complications* / Q000628:therapy*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications* / Q000628:therapy*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D015607:Stents; D020521:Stroke / Q000517:prevention & control; D016896:Treatment Outcome