title: Management of concomitant coronary and bilateral carotid artery disease: a case report.
abstract: Patients with severe coexistent coronary and carotid artery stenosis represent a difficult and high-risk population. Herein we describe management of a patient with concomitant coronary artery and bilateral carotid artery disease. Firstly, left carotid artery stenting was done using a self-expandable monorail stent and a neurological protective device. Post-stent angiogram revealed satisfactory dilatation in the left carotid artery. Later, coronary artery bypass grafting to the four coronary arteries was done. Then right carotid endarterectomy was done. He had no neurological complication during or after any of the operation and he remains in good health since his last operation. We think the staged treatment, consisting of carotid artery stenting plus coronary artery bypass grafting plus carotid endarterectomy, in a patient with concomitant severe coronary artery and bilateral carotid artery disease is feasible, safe, and may be an alternative to combined coronary artery bypass grafting plus carotid endarterectomy.
authors.affiliation: Department of Cardiovascular Surgery, Süleyman Demirel University Medical School, Isparta, Turkey. kirisilker@yahoo.com
authors.forename: Ilker
authors.initials: I
authors.lastname: Kiriş
authors.forename: Senol
authors.initials: S
authors.lastname: Gülmen
authors.forename: Saim
authors.initials: S
authors.lastname: Yilmaz
authors.forename: Huseyin
authors.initials: H
authors.lastname: Okutan
mesh_terms: D000368:Aged; D000792:Angiography; D019917:Blood Vessel Prosthesis Implantation; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000601:surgery*; D016893:Carotid Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000150:complications / Q000601:surgery*; D016894:Endarterectomy, Carotid; D006801:Humans; D008297:Male; D015607:Stents