Revascularization by carotid artery stenting and off‐pump coronary artery bypass

Yang, Tao; Zhang, Lefeng; Wang, Xinqiang; Dong, Hua; Jiang, Xiongjing; Sun, Hansong

doi:10.1111/ans.12586

Cited by 9 publications

(23 citation statements)

References 23 publications

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“…A stenosis threshold of 70% was adopted in eight studies, 14,25,27e32 while a >80% stenosis was adopted in 16 studies. 13,15e19,21,23,33e40 In previously symptomatic patients, the stenosis threshold for performing CAS þ CABG was 50% in six studies, 30,31,35,36,39,40 especially if the patient had a contralateral occlusion. 27 The threshold was 60% in three studies 19,20,29 and 70% in 11 studies, 14,17,18,23e25,27,32e34,38 while Guerra et al 37 adopted >80% as the threshold for intervening in previously symptomatic patients.…”

Section: Subgroup Analysesmentioning

confidence: 99%

“…Of the 372 CAS þ CABG patients with a prior history of stroke/TIA/amaurosis, only 143 patients (derived from 6 studies) 14,19,24,29,31,54 had outcome data that were provided separately for symptomatic patients ( Table 4). The only parameter reported in each study was 30-day stroke.…”

Section: Records Identified Throughmentioning

confidence: 99%

“…12,32e36,38,40 In five studies (323 patients), dual antiplatelet therapy was started prior to CAS and then reduced to one antiplatelet agent prior to CABG. 5,18,25,31,37 In four studies (475 patients), dual antiplatelet therapy was started prior to CAS, but then both antiplatelet agents were stopped prior to CABG. 16,17,20,21 In five studies (127 patients), dual antiplatelet therapy was started before CAS and was not stopped prior to CABG.…”

Section: Records Identified Throughmentioning

confidence: 99%

“…16,17,20,21 In five studies (127 patients), dual antiplatelet therapy was started before CAS and was not stopped prior to CABG. 14,15,22,31,39 Because of significant heterogeneity between studies, it was not possible to perform meaningful comparative statistical analyses. Notwithstanding potential biases, however, the main observation ( Table 5) was that stopping dual antiplatelet therapy prior to CABG seemed to be associated with higher procedural risks (death/stroke, 13.4%; death/ stroke/MI, 14.4%).…”

Section: Records Identified Throughmentioning

confidence: 99%

See 3 more Smart Citations

Carotid Stenting Prior to Coronary Bypass Surgery: An Updated Systematic Review and Meta-Analysis

Paraskevas

Nduwayo

Saratzis

et al. 2017

European Journal of Vascular and Endovascular Surgery

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In a cohort of predominantly asymptomatic patients with unilateral carotid stenoses, the 30-day rate of death/stroke was about 8%. Notwithstanding the effect of potential biases, this meta-analysis did not find evidence that outcomes after same-day CAS + CABG were higher than after staged interventions. However, outcomes were poorer in neurologically symptomatic patients. More data are required to establish the optimal antiplatelet strategy in patients undergoing same-day or staged CAS + CABG.

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Section: Subgroup Analysesmentioning

confidence: 99%

Section: Records Identified Throughmentioning

confidence: 99%

Section: Records Identified Throughmentioning

confidence: 99%

Section: Records Identified Throughmentioning

confidence: 99%

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Carotid Stenting Prior to Coronary Bypass Surgery: An Updated Systematic Review and Meta-Analysis

Paraskevas

Nduwayo

Saratzis

et al. 2017

European Journal of Vascular and Endovascular Surgery

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“…All four studies were observational and they included a total of 357 patients. [19][20][21][22] Baseline patient characteristics are summarized in Table 1. Two of the included studies were assessed as having moderate risk of bias, while two studies had low risk of bias (Supplementary Table 2).…”

Section: Characteristics Of the Studies And Patientsmentioning

confidence: 99%

Synchronous versus staged carotid artery stenting and coronary artery bypass graft for patients with concomitant severe coronary and carotid artery stenosis: A systematic review and meta-analysis

Tzoumas

Giannopoulos²,

Charisis

et al. 2020

Vascular

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Background Coronary artery disease requiring coronary artery bypass graft (CABG) frequently coexists with critical carotid stenosis. The most optimized strategy for treating concomitant carotid and coronary artery disease remains debatable. Objective The aim of this meta-analysis was to compare synchronous CAS and CABG versus staged CAS and CABG for patients with concomitant coronary artery disease and carotid artery stenosis in terms of peri-operative (30-day) and long-term clinical outcomes. Methods This study was performed according to the PRISMA guidelines. Eligible studies were identified through a search of PubMed, Scopus and Cochrane database until December 2019. A meta-analysis was conducted with the use of a random effects model. The I-square statistic was used to assess heterogeneity. Results Four studies comprising 357 patients were included in this meta-analysis. Patients who were treated with the synchronous approach had a statistically significant higher risk for peri-operative stoke (OR: 3.71; 95% CI: 1.00–13.69; I2 = 0%) compared tο the staged group. Peri-operative mortality (OR: 4.50; 95% CI: 0.88–23.01; I2 = 0%), myocardial infarction (MI) (OR: 1.54; 95% CI: 0.18– 13.09; I2 = 0%), postoperative bleeding (OR: 0.27;95% CI: 0.02–3.12; I2 = 0%), transient ischemic attacks (TIA) (OR: 0.60; 95% CI: 0.04– 9.20; I2 = 0.0%), acute kidney injury (AKI) (OR: 0.34; 95% CI: 0.03–4.03; I2 = 0.0%) and atrial fibrillation rates (OR:0.27; 95% CI: 0.02–3.12; I2 = 0.0%) were similar between the two groups. Synchronous CAS-CABG and staged CAS followed by CABG were associated with similar rates of late mortality (OR: 3.75; 95% CI: 0.50–27.94; I2 = 0.0%), MI (OR: 0.33; 95% CI: 0.01–12.03; I2 = 0.0%) and stroke (OR:3.58; 95% CI:0.84–15.20; I2 = 0.0%) after a mean follow-up of 47 months. Conclusion The simultaneous approach was associated with an increased risk of 30-day stroke compared to staged CAS and CABG. However, no statistically significant difference was found in long-term results of mortality, MI and stroke between the two approaches. Future studies are warranted to validate our results.

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Management of Patients with Concomitant Coronary and Carotid Artery Disease

Santarpino

Fina

Simeone

et al. 2023

Ischemic Heart Disease

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Revascularization by carotid artery stenting and off‐pump coronary artery bypass

Cited by 9 publications

References 23 publications

Carotid Stenting Prior to Coronary Bypass Surgery: An Updated Systematic Review and Meta-Analysis

Carotid Stenting Prior to Coronary Bypass Surgery: An Updated Systematic Review and Meta-Analysis

Synchronous versus staged carotid artery stenting and coronary artery bypass graft for patients with concomitant severe coronary and carotid artery stenosis: A systematic review and meta-analysis

Management of Patients with Concomitant Coronary and Carotid Artery Disease

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