Management of Coexistent Carotid and Coronary Artery Disease

Dp, Halpin; Riggins, Shefton L.; Jd, Carmichael; Jh, Isobe; Jl, Mathews; Ws, Blakemore; Dr, Kahn; Ta, Gaskin

doi:10.1097/00007611-199402000-00007

Cited by 22 publications

(2 citation statements)

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“…Consider the practitioner seeking evidence from the literature as to the best management of the patient with advanced carotid and coronary artery disease in whom surgery on both is indicated. Among reports published during the last decade of over 100 cases of combined carotid endarterectomy and coronary artery bypass grafting, operative mortality rates vary from zero to 5.5%, stroke rates from 2.3 to 7.1%, and perioperative myocardial infarction rates from zero to 4.7% [28][29][30][31][32][33] . Comparison of reports from various operators at different times is complicated by variations in case mix, in surgical technique and in the perioperative management of the patients.…”

Section: The Influence Of the Operator And Local Systems In Surgical mentioning

confidence: 99%

Evidence-Based Medicine and Anaesthesia: Uneasy Bedfellows?

Horan

1997

Anaesth Intensive Care

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The term "evidence-based medicine" first appeared in the medical literature in 1992 and is in widespread use today. It is timely to examine the concept's relevance to anaesthetic practice as well as the validity of the premises on which it rests. An important difference between anaesthesia and the specialties which treat disease is that in anaesthesia there is very little research done with real outcomes as its end-point. Surrogate or intermediate outcomes predominate as the end-points of anaesthetic research, which is a weakness when the results serve as the evidence on which to base clinical decisions. Furthermore, in interventions which require personal skill, dexterity or decision-making, caution must be exercised in assuming that equally good outcomes are achievable by all. Key members of the Cochrane Collaboration, among the most prominent advocates of evidence-based medicine, promote the belief that much valid scientific evidence is to be found in sources outside the peer-reviewed published literature. This assertion must be treated with caution. Furthermore, some techniques central to the search for the evidence on which to base practice, including meta-analysis and multicentre trials, are prone to errors through incorrect application. Evidence-based medicine appears to have less to offer anaesthesia than it does to the "treating" specialties.

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Section: The Influence Of the Operator And Local Systems In Surgical mentioning

confidence: 99%

Evidence-Based Medicine and Anaesthesia: Uneasy Bedfellows?

Horan

1997

Anaesth Intensive Care

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“…The benefits of either staged or combined carotid endarterectomy (CEA) as the surgical intervention of choice, however, have not been definitively established. The optimal method for surgical management, therefore, remains controversial [2][3][4]. A review of the literature revealed an incidence of cardiac and neurological complications which ranged up to 5.5% and 9.2%, respectively, in combined surgical procedures [2,[5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%