Carotid Revascularization Before Open Heart Surgery: The Data-Driven Treatment Strategy∗

Optimal management of high-grade obstructive carotid artery disease at the time of open heart surgery (OHS) has never been addressed in a randomized clinical trial. Data suggest that the combined approach of carotid endarterectomy (CEA) and OHS leads to a higher risk of procedural stroke , and, therefore, staged carotid revascularization by CEA or carotid artery stenting (CAS) is often performed before OHS. Does the staged approach lead to an overall reduction in the rate of major adverse cardiovascular events (MACE = death, myocardial infarction, and stroke) for patients with concomitant coronary and cerebrovascular disease? The current study reported in this issue of the Journal by Shishehbor et al. would suggest that this is true, but only for staged CAS followed by OHS.
Source: Journal of the American College of Cardiology - Category: Cardiology Authors: Tags: Coronary Artery Disease: Editorial Comment Source Type: research