Carotid endarterectomy for carotid stenosis in patients selected for coronary artery bypass graft surgery

Hejri, Sara Mortaz; Davani, Babak Mostafazadeh; Sahraian, Mohammad Ali

doi:10.1002/14651858.cd006074.pub2

Cited by 12 publications

(8 citation statements)

References 28 publications

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“…As other findings, hypertensive patients were found to have a higher value of c-IMT than normotensive ones. Regarding the association between the presence of diabetes and increased measure of c-IMT, this association was only found in the control group not in the case group similar to some previous studies (34,43). This contradictory result can be due to the abnormal distribution of cases in the NAFLD group.…”

Section: Discussionsupporting

confidence: 77%

“…Some risk factors for coronary artery disease or carotid atherosclerosis can be commonly found in NAFLD. In this regard, simultaneously occurring NAFLD and atherosclerosis patterns can be shown in 2.3% to 54% of patients (32)(33)(34). Advanced age, female gender, hypertension, diabetes, and smoking potentially increase the likelihood for both coronary stenosis and carotid artery atherosclerosis (35,36).…”

Section: Introductionmentioning

confidence: 99%

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Association of Non-Alcoholic Fatty Liver Disease with Increased Carotid Intima-Media Thickness Considering Other Cardiovascular Risk Factors

et al. 2019

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Background: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease (6%-35%) and is associated with cardiovascular risk factors and metabolic syndromes (age, diabetes, hyperlipidemia, hypertension and smoking). Hereby, we evaluated the association of increased carotid intima-media thickness (IMT) with NAFLD considering other cardiovascular risk factors to see if NAFLD is independently associated with increased carotid IMT. Patients and Methods: Totally 300 patients [150 NAFLD and 150 normal] who were referred to four academic referral hospitals were enrolled. Patients with a history of alcohol use, hepatitis, HIV, chemotherapy and other organ failures were excluded. A single radiologist performed abdominal sonographies [3-5 MHz probe] and carotid sonography [7.5 MHz probe] (measured the posterior wall of both common carotids and calculated the mean value). NAFLD was diagnosed based on sonographic findings in the absence of acute or chronic liver and kidney diseases and malignancies. Results: The mean age was 51.2 ± 14.8 [20-97] and 184 [61.3%] were male. Mean IMT was greater in patients with diabetes, hypertension, hyperlipidemia and NAFLD [all Ps < 0.001] and these variables with age were statistically significant in univariate models for estimating IMT. Among NAFLD patients, 38 [25.3%] had increased IMT [unilateral or bilateral; considering 0.8 as cutoff point] while this frequency was 8 [%5.3] among normal subjects [P < 0.001, odds ratio = 6, 95% confidence interval (CI) = 2.7-13.4]. In multivariate regression models [IMT as dependent variable], NAFLD, age and hyperlipoproteinemia (HLP) were independent significant variables in linear model [R 2 = 0.41] and NAFLD showed highest odds ratio [16.4] among significant variables [age, body mass index (BMI), NAFLD and HLP] in the logistic model. Conclusion: Increase carotid IMT is highly associated with NAFLD independent of other cardiovascular risk factors and should be considered in these patients.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Association of Non-Alcoholic Fatty Liver Disease with Increased Carotid Intima-Media Thickness Considering Other Cardiovascular Risk Factors

et al. 2019

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“…No ongoing or completed randomized trial has assessed whether a combined synchronous or staged CEA and CABG operation confers any benefit compared with isolated CABG (17). A recent systematic review of perioperative outcomes following synchronous CEA and CABG revealed a complication rate of 8·2% (95% CI 7·1–9·3%) for perioperative stroke or death in 5386 patients (3).…”

Section: Discussionmentioning

confidence: 99%

Randomized Comparison of Synchronous CABG and Carotid Endarterectomy vs. Isolated CABG in Patients with Asymptomatic Carotid Stenosis: The CABACS Trial

Knipp

Scherag

Beyersdorf

et al. 2011

International Journal of Stroke

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“… 6 Patients with a history of TIA or stroke and severe carotid artery stenosis have a higher risk of post-CABG stroke and will likely benefit from revascularization. 15 The ACC guidelines comment that timing and sequence of carotid and coronary revascularization is based on the absence or presence of clinical symptoms. 6 …”

Section: Screening For Carotid Artery Stenosis In Patients Undergoingmentioning

confidence: 99%

Coexisting Coronary and Carotid Artery Disease – Which Technique and in Which Order? Case Report and Review of Literature

Manthey

Spears

Goldberg

2020

Clin Med Insights Cardiol

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Coexisting carotid artery stenosis and coronary artery disease is common and there is currently no consensus in treatment guidelines on the timing, sequence and methods of revascularization. We report a case of a patient with symptomatic triple vessel coronary artery disease as well as asymptomatic severe right internal carotid artery stenosis. Our patient underwent myocardial revascularization first, because she presented with unstable angina and was asymptomatic neurologically. This article summarizes current literature about the approach to carotid and coronary artery revascularization and addresses the decision-making process regarding the timing and sequence of revascularization.

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Carotid endarterectomy for carotid stenosis in patients selected for coronary artery bypass graft surgery

Cited by 12 publications

References 28 publications

Association of Non-Alcoholic Fatty Liver Disease with Increased Carotid Intima-Media Thickness Considering Other Cardiovascular Risk Factors

Association of Non-Alcoholic Fatty Liver Disease with Increased Carotid Intima-Media Thickness Considering Other Cardiovascular Risk Factors

Randomized Comparison of Synchronous CABG and Carotid Endarterectomy vs. Isolated CABG in Patients with Asymptomatic Carotid Stenosis: The CABACS Trial

Coexisting Coronary and Carotid Artery Disease – Which Technique and in Which Order? Case Report and Review of Literature

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