Carotid artery stenting followed by open heart surgery in 323 patients: One‐year results and influencing factors

Dong, Hua; Che, Wuqiang; Jiang, Xiongjing; Peng, Meng; Zou, Yubao; Xiong, Hongliang; Chen, Yang; Xu, Bo; Yang, Yuejin; Gao, Runlin

doi:10.1002/ccd.27486

Cited by 6 publications

(6 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Shishehbor et al 12 demonstrated that staged CAS-OHS should be considered as a first-line strategy if the 3-to 4-week delay to OHS is clinically acceptable. Recently, Dong et al 28 analyzed the influencing factors on major cardiovascular events and showed that patients with an interval of more than 5 days between CAS and OHS had significantly higher rates of 1-year freedom from combined major stroke, MI, and death from any cause than those with an interval of 5 days or fewer between CAS and OHS (96.2% vs 85.6%; P ¼ .001). However, in our study, the median staging interval time between CAS and CABG was 43.51 days after CAS.…”

Section: Discussionmentioning

confidence: 99%

Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization

Xiang

Luo

Yang

et al. 2019

Journal of Vascular Surgery

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization

Xiang

Luo

Yang

et al. 2019

Journal of Vascular Surgery

View full text Add to dashboard Cite

“…3 Dong et al, in a recent study of 323 consecutive CAS-CTS patients, reported that "interlude" duration (time between procedures) of <5 days was associated with the primary composite endpoint, which suggests that the option of longer interlude duration may be appropriate for medically high-risk patients. 12 The choice of eptifibatide as a second antiplatelet offers several key advantages over conventional DAPT protocols based on an aspirin/clopidogrel combination. Eptifibatide, along with GIIBIIIA agents abciximab and tirofiban, emerged in the early 2000s in several large, randomized trials for coronary intervention, though there is relative paucity of data for its use in CAS.…”

Section: Discussionmentioning

confidence: 99%

Eptifibatide bridging therapy for staged carotid artery stenting and cardiac surgery: Safety and feasibility

et al. 2022

View full text Add to dashboard Cite

Background Prophylactic carotid artery stenting (CAS) is an effective strategy to reduce perioperative stroke in patients with severe carotid stenosis who require cardiothoracic surgery (CTS). Staging both procedures (CAS-CTS) during a single hospitalization presents conflicting demands for antiplatelet therapy and the optimal pharmacologic strategy between procedures is not established. The purpose of this study is to present our initial experience with a “bridging” protocol for staged CAS-CTS. Methods A retrospective review of staged CAS-CTS procedures at a single referral center was performed. All patients had multivessel coronary and/or valvular disease and severe carotid stenosis (>70%). Patients not previously on aspirin were also started on aspirin prior to surgery, followed by eptifibatide during CAS (intraprocedural bolus followed by post-procedural infusion which was continued until the morning of surgery). Pre- and perioperative (30 days) neurologic morbidity and mortality was the primary endpoint. Results 11 CAS procedures were performed in 10 patients using the protocol. The median duration of eptifibatide bridge therapy was 36 h (range 24–288 h). There was one minor bleeding complication (1/11, 9.1%) and no major bleeding complications during the bridging and post-operative period. There was one post-operative, non-neurologic death and zero perioperative ischemic strokes. Conclusions For patients undergoing staged CAS-CTS, Eptifibatide bridging therapy is a viable temporary antiplatelet strategy with a favorable safety profile. This strategy enables a flexible range of time-intervals between procedures.

show abstract

“…These results confirmed that simultaneous surgical treatment increases trauma and the prevalence of adverse outcomes during the perioperative period. 2,5,12,16…”

Section: Discussionmentioning

confidence: 99%

“…2,6,7,9,11 The revascularisation in patients with high-grade carotid stenosis by stage or simultaneous with the CABG procedure is recommended to reduce the incidence of cerebrovascular events. 12,13 Giannopoulos et al presented a hybrid method as a satisfying alternative to simultaneous surgical revascularisation, especially in high-risk patients. 9 The CEA and CABG staged procedure decreased cerebrovascular events but increased the chance of myocardial events.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term results after simultaneous carotid and coronary revascularisation

Živković

Krasić

Milačić

et al. 2022

Asian Cardiovasc Thorac Ann

View full text Add to dashboard Cite

Background The revascularisation strategy for concomitant carotid and coronary disease is unknown. Simultaneous or stage coronary artery stenting and carotid endarterectomy are the most common revascularisation approach in the CABG population. This study aimed to evaluate long-term results after simultaneous carotid artery stenting or carotid endarterectomy in patients who underwent coronary artery bypass surgery. Methods This is a prospective cohort non-randomised single-institution study. During the period from 2012 to 2015, sixty consecutive patients (65.9 ± 7.41 mean) underwent simultaneous carotid artery stenting and coronary artery bypass surgery ( n = 30) or simultaneous carotid endarterectomy and coronary artery bypass surgery ( n = 30). The primary endpoints were short- and long-term rates of adverse events (transient ischemic attack, stroke, myocardial infarction, and death). The mean follow-up was 62.05 ± 11.12 months. Results In-hospital mortality was insignificantly higher in the carotid endarterectomy, and coronary artery bypass surgery group (6.6% vs. 0%), the rate of stroke and myocardial infarction was similar (13.3% and 0% in the carotid endarterectomy and coronary artery bypass surgery group vs. 6.6% and 3.3% in the carotid artery stenting and coronary artery bypass surgery group, respectively). The intensive care unit readmission was significantly higher in the surgical revascularisation approach; it was an independent predictor of hospital mortality. The overall mortality during the follow-up period was 14.28% in both groups. Freedom of the composite adverse outcomes (stroke, myocardial infarction, and death) was 78.55%. Conclusion Comparing two revascularisation strategies is not straightforward due to different anatomical indications for carotid artery stenting and endarterectomy. We consider that each technique has an essential role in carotid revascularisation. Good selection of patients, according to indications, contributes to satisfactory short- and long-term results.

show abstract

Carotid artery stenting followed by open heart surgery in 323 patients: One‐year results and influencing factors

Abstract: CAS followed by OHS is a safe and effective treatment for patients with concomitant carotid and cardiac disease within 1-year follow up. The interval between CAS and OHS, congestive heart failure, and renal insufficiency could obviously influence the 1-year results.

Cited by 6 publications

References 17 publications

Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization

Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization

Eptifibatide bridging therapy for staged carotid artery stenting and cardiac surgery: Safety and feasibility

Long-term results after simultaneous carotid and coronary revascularisation

Contact Info

Product

Resources

About