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Optimal management of carotid artery disease in patients undergoing coronary artery bypass
It is well-known that patients undergoing coronary artery bypass grafting (CABG) with coexisting carotid artery disease are at increased risk for perioperative stroke and death. The prevalence of carotid disease among patients undergoing CABG is 6% to 14%,1 and the risk of stroke following CABG increases from 3% for unilateral 50% to 99% stenosis to 5% for bilateral 50% to 99% stenoses and 10% for carotid occlusion.2 The risk of stroke and death are notably higher in patients with a history of transient ischemic attack (TIA)/stroke.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Christopher K. Zarins Tags: Invited commentary Source Type: research

Systematic Review and Meta-Analysis of the Treatment Strategies for Coronary Artery Bypass Graft Patients with Concomitant Carotid Artery Atherosclerotic Disease
Stroke is one of the devastating complications following coronary artery bypass graft (CABG). Underlying carotid artery atherosclerotic disease is reported to be an independent risk factor. The optimal treatment strategy for these patients remains under debate.
Source: Journal of Vascular Surgery - May 28, 2023 Category: Surgery Authors: Junji Tsukagoshi, Yujiro Yokoyama, Tomohiro Fujisaki, Hisato Takagi, Takuro Shirasu, Toshiki Kuno Source Type: research

Carotid endarterectomy should be performed first rather than combined with coronary bypass
I read with interest the article addressing timing of carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG)1 since I had just been referred a patient from a cardiac surgeon with the need for both CEA and CABG. I was gratified to learn that in patients with stable angina, performing CEA first compared equally to combined CEA and CABG (CCAB) with regard to both stroke rate and myocardial infarction (MI). From a strictly scheduling standpoint, performing a staged procedure is easier on surgeons and staff.
Source: Journal of Vascular Surgery - November 19, 2020 Category: Surgery Authors: Joseph J. Piotrowski Tags: Letter to the Editor Source Type: research

Carotid endarterectomy is not indicated for most patients scheduled for coronary artery bypass grafting
Klarin et  al1 evaluated whether performing concomitant carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) in patients with concurrent carotid and coronary atherosclerotic disease is associated with reduced postoperative stroke rates compared with those undergoing CABG alone (ie, without CEA).1 They included 994 off-pump CABG patients (497 CABG only and 497 CABG-CEA) and 5952 on-pump CABG patients (2976 CABG only and 2976 CABG-CEA). For on-pump operations, patients undergoing concomitant CEA and CABG had no difference in rates of in-hospital stroke (odds ratio [OR], 0.93; 95% confi dence interval [CI]...
Source: Journal of Vascular Surgery - July 22, 2020 Category: Surgery Authors: Kosmas I. Paraskevas Tags: Letter to the Editor Source Type: research

Concomitant carotid endarterectomy and cardiac surgery does not decrease postoperative stroke rates
We examined the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database to evaluate the association of combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) with postoperative outcomes.
Source: Journal of Vascular Surgery - February 13, 2020 Category: Surgery Authors: Derek Klarin, Virendra I. Patel, Shuaiqi Zhang, Ying Xian, Andrzej Kosinski, Babatunde Yerokun, Vinay Badhwar, Vinod H. Thourani, Thoralf M. Sundt, David Shahian, Serguei Melnitchouk Source Type: research

A Propensity Score Matched Analysis of Asymptomatic Patients Undergoing Carotid Endarterectomy (CEA) vs Coronary Artery Bypass Graft (CABG) vs Combined CEA-CABG in the ACS-NSQIP
Carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) may be combined to treat concomitant coronary artery and carotid artery atherosclerotic disease. Previous reports on combined CEA/CABG have shown wide variation in adverse event rates for asymptomatic patients and have often been limited by small sample size or lack of granularity, or both. We aim to compare stroke and death after CEA/CABG with CEA or CABG alone in asymptomatic patients by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database.
Source: Journal of Vascular Surgery - January 24, 2014 Category: Surgery Authors: Li Wang, Thomas Curran, John C. McCallum, Dominique Buck, Jeremy Darling, Mark Wyers, Raul J. Guzman, Allen Hamdan, Elliot Chaikof, Marc L. Schermerhorn Tags: Abstracts from the 2014 Society for Clinical Vascular Surgery Annual Symposium Source Type: research