Regional use of combined carotid endarterectomy/coronary artery bypass graft and the effect of patient risk.

Journal of Vascular Surgery
Douglas W JonesPhilip P Goodney

Abstract

Although carotid artery stenosis and coronary artery disease often coexist, many debate which patients are best served by combined concurrent revascularization (carotid endarterectomy [CEA]/coronary artery bypass graft [CABG]). We studied the use of CEA/CABG in New England and compared indications and outcomes, including stratification by risk, symptoms, and performing center. Using data from the Vascular Study Group of New England from 2003 to 2009, we studied all patients who underwent combined CEA/CABG across six centers in New England. Our main outcome measure was in-hospital stroke or death. We compared outcomes between all patients undergoing combined CEA/CABG to a baseline CEA risk group comprised of patients undergoing isolated CEA at non-CEA/CABG centers. Further, we compared in-hospital stroke and death rates between high and low neurologic risk patients, defining high neurologic risk patients as those who had at least one of the following clinical or anatomic features: (1) symptomatic carotid disease, (2) bilateral carotid stenosis >70%, (3) ipsilateral stenosis >70% and contralateral occlusion, or (4) ipsilateral or bilateral occlusion. Overall, compared to patients undergoing isolated CEA at non-CEA/CABG centers (n...Continue Reading

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Citations

Apr 29, 2014·Current Problems in Surgery·C Keith OzakiEdwin C Gravereaux
Jul 31, 2013·Journal of Vascular Surgery·Carlos Saadeh, Julien Sfeir
Aug 13, 2014·Anesthesiology Clinics·Daryl A Oakes, Kenneth D Eichenbaum
Feb 18, 2020·Journal of Surgical Case Reports·Dante C DaliShahab A Akhter
Mar 30, 2019·Journal of Vascular Surgery·Linda J WangW Darrin Clouse

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