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Simultaneous Carotid and Coronary Artery Surgery in Asymptomatic Carotid Artery Stenosis : Report of three cases Yoji KOMATSU 1 , Kei NAKAI 1 , Kazuyasu AOKI 1 , Kazuya UEMURA 1 , Tomoyuki SHIBATA 1 , Takashi YOSHIZAWA 1 , Eiki KOBAYASHI 1 , Tadashi KOISHIZAWA 2 , Yuzuru SAKAKIBARA 2 , Yuji HIRAMATSU 2 , Tadao NOSE 3 1Department of Neurosurgery, Tsukuba Memorial Hospital 2Department of Cardiovascular Surgery, Tsukuba Memorial Hospital 3Department of Neurosurgery, Institute of Clinical Medicine, Tsukuba University Keyword: carotid endarterectomy , coronary artery bypass graft , simultaneous surgery , combined surgery pp.65-69
Published Date 2001/1/10
DOI https://doi.org/10.11477/mf.1436902000
  • Abstract
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Some patients with coronary artery disease are diagnosed as having additional carotid artery disease. This subset of patients has been identified as a high-risk group for cardiac and cerebral complications fol- lowing surgical intervention. Three patients who underwent combined CEA/CABG for coexistent asymp- tomatic carotid occlusive disease are reported.

Case 1 : A 69-year-old female who suffered chest pain on exertion. Her coronary angiogram showed se- vere stenosis of three vessels. Her carotid angiogram showed 98% stenosis of the right internal carotid artery and poor collateral circulation. The severe stenosis of her carotid artery was considered as a riskfactor for perioperative cerebral stroke. Intraoperatively, CEA preceded the CABG. Postoperative coursewas uneventful.

Case 2: A 64-year-old male. Intermittent claudication was his initial symptom. His coronary angiogramshowed stenosis in three vessels and carotid angiogram showed 75% stenosis in the right carotid artery.Simultaneous CABG and CEA was performed. His postoperative course was uneventful.

Case 3: A 62-year-old male whose ECG indicated ischemic heart disease, although he had no symptoms.His coronary angiogram showed stenosis in three vessels, and 80% stenosis of his right carotid artery wasobserved by carotid angiogram. He underwent simultaneous surgery, and had an uneventful postoperativecourse.

It has been reported that 1.5~8.7% of CABG patients have severe carotid artery stenosis, and periopera-tive cerebral stroke occurrs in 0.9~16%. Simultaneous surgery was successful in our three patients whohad asymptomatic carotid artery stenosis. Using this surgical approach for critical coexistent disease mayminimize the incidence of perioperative cerebrovascular complications in patients undergoing CABG.


Copyright © 2001, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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