Risk factors for major complications due to delay in surgery in staged carotid stenting and coronary bypass graft surgery.
OBJECTIVE
To answer the question whether the delay in coronary artery bypass grafting (CABG) after carotid stenting (CAS) results in adverse events, we describe our experience with planned staged CAS followed by CABG.


RESULTS
We retrospectively surveyed our hospital carotid stenting data base, to identify all patients who were scheduled to undergo staged carotid stenting followed by CABG. A total of 39 patients who underwent CAS were candidates for staged CABG but only 28 (71.7%) of them referred. In the interval between carotid stenting and CABG, 4 deaths occurred (14.2% of cases), all of them were in the first week after CAS and due to cardiac problems. Also, 2 patients (7.1%) had a minor stroke. Increased number of predictors of type C (most important was stenosis of 95%-99%), age > 75 or significant valvular heart disease were associated with increased rate of complications after CAS.


CONCLUSIONS
Should carotid intervention be performed in the high risk group of patients with > 4 suggested predictors of type C (most importantly is stenosis of 95%-99%), valvular heart disease or age > 75, physicians should closely observe the patients (perhaps in the hospital) during the waiting period before CABG, particularly in the first week after carotid stenting.
Kassaian
Seyed Ebrahim
SE
Interventional Cardiologist, Tehran Heart Center, Medical Sciences, University of Tehran, Tehran, Iran.
Alidoosti
Mohammad
M
Saleh
Davood Kazemi
DK
Zeinali
Ali Mohammad Haji
AM
Salarifar
Mojtaba
M
Sahraian
Ali Mohammad
AM
Shirani
Shapour
S
Kazazi
Elham Hakki
EH
Darvish
Soodabeh
S
Marzban
Mehrab
M
Abbasi
Seyed Hesameddin
SH
Massumi
Ali
A