Balbaa, S., Balbaa, Y. (2006). TREATMENT OF ASSOCIATED CAROTID AND CORONARY DISEASE. test, 25(2), 95-100. doi: 10.21608/ejsur.2006.373089
Sherif Balbaa; Yehia Balbaa. "TREATMENT OF ASSOCIATED CAROTID AND CORONARY DISEASE". test, 25, 2, 2006, 95-100. doi: 10.21608/ejsur.2006.373089
Balbaa, S., Balbaa, Y. (2006). 'TREATMENT OF ASSOCIATED CAROTID AND CORONARY DISEASE', test, 25(2), pp. 95-100. doi: 10.21608/ejsur.2006.373089
Balbaa, S., Balbaa, Y. TREATMENT OF ASSOCIATED CAROTID AND CORONARY DISEASE. test, 2006; 25(2): 95-100. doi: 10.21608/ejsur.2006.373089

TREATMENT OF ASSOCIATED CAROTID AND CORONARY DISEASE

The Egyptian Journal of Surgery
Volume 25, Issue 2, April 2006, Pages 95-100    PDF (151.25 K)
Document Type: Original Article
DOI: 10.21608/ejsur.2006.373089
Authors
Sherif Balbaa* 1; Yehia Balbaa2
1Department of General Surgery, Faculty of Medicine, Cairo University
2Department of Cardiothoracic Surgery, Faculty of Medicine, Cairo University, Egypt
Abstract
Aim: The management of patients with combined carotid and coronary artery disease is controversial. Myocardial infarction is the most common cause of early and late mortality after carotid endarterectomy (CEA), and stroke after coronary artery bypass grafting (CABG) is a devastating and dreaded complication. This study aims to address different treatment strategies in patients with combined diseases. 
Methods: Thirty five patients with combined carotid artery stenosis and coronary artery disease were included in this case series. All patients were candidates for CABG, and their carotid status was either symptomatic or asymptomatic with 
critical stenosis. CEA either preceded CABG (the staged procedure) in 22 cases, was done in conjunction with CABG (the 
combined procedure) in 8 cases, or followed CABG (the reversed staged procedure) in 5 cases. 
Results: The mean age of study population was 71 ± 7.0 years. Five patients (14.2%) had suffered a previous stroke. The study had a single mortality (2.85%; cardiac in origin), one myocardial infraction, and 2 cerebrovascular strokes (5.7%). Two patients suffered temporary 12th nerve dysfunction. 
Conclusion: Patients with severe, symptomatic disease in both the carotid and coronary artery territories probably benefit from a combined revascularization. In patients with stable disease in one of the vascular territories, the choice of a staged, combined, or reversed staged procedure is more controversial. 
Keywords
Cardiac bypass; cerebral ischaemia; endarterectomy
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