Management of combined severe carotid and coronary artery disease.

Abstract:

:Patients with severe carotid and coronary disease-especially if they require coronary artery bypass grafting (CABG)-are at high risk of cardiac events and stroke. Carotid revascularization should be considered for patients with symptomatic carotid disease and bilateral severe asymptomatic carotid stenosis. In patients with unilateral asymptomatic carotid stenosis, decision to proceed to revascularization should be based more on a perspective of long-term stroke prevention than of perioperative stroke reduction. Compared with endarterectomy, carotid artery stenting is associated with a lower incidence of periprocedural myocardial infarction, an event linked to long-term mortality. This observation may be particularly relevant for patients with advanced coronary artery disease such as those undergoing CABG. Irrespective of the carotid revascularization strategy, a broad disease management approach based on lifestyle modification and pharmacologic cardiovascular prevention is more likely to affect both the quality and duration of life than revascularization itself.

journal_name

Curr Cardiol Rep

authors

Roffi M,Ribichini F,Castriota F,Cremonesi A

doi

10.1007/s11886-012-0246-1

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

125-34

issue

2

eissn

1523-3782

issn

1534-3170

journal_volume

14

pub_type

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