Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened

Detalhes bibliográficos
Autor(a) principal: Güney,Mehmet Raşit
Data de Publicação: 2022
Outros Autores: Güler,Erhan, Albay,Erkan, Kehlibar,Tamer, Yilmaz,Mehmet, Ketenci,Bülend
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Cardiovascular Surgery (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000500648
Resumo: ABSTRACT Introduction: There is no complete consensus on the three surgical methods and long-term consequences for coexisting coronary and carotid artery disease. We retrospectively evaluated the surgical results in this high-risk group in our clinic for a decade. Methods: Between 2005 and 2015, 196 patients were treated for combined carotid and coronary artery disease. A total of 50 patients were operated on with the staged method, 40 of which had carotid endarterectomy (CEA) priority, and 10 had coronary artery bypass grafting (CABG) priority. CABG and CEA were simultaneously performed in 82 patients; and in 64 asymptomatic patients with unilateral carotid artery lesions and stenosis over 70%, only CABG was done (64 patients). Results were evaluated by uni-/multivariate analyses for perioperative, early, and late postoperative data. Results: In the staged group, interval between the operations was 2.82±0.74 months. Perioperative and early postoperative (30 days) parameters did not differ between groups (P-value < 0.05). Postoperative follow-up time was averaged 94.9±38.3 months. Postoperative events were examined in three groups as (A) deaths (all cause), (B) cardiovascular events (non-fatal myocardial infarction, recurrent angina, congestive heart failure, palpitation), and (C) fatal neurological events (amaurosis fugax, transient ischemic attack, and stroke). When group C events were excluded, event-free actuarial survival rates were similar in all three methods (P=0.740). Actuarial survival rate was significantly different when all events were included (P=0.027). Neurological events increased markedly between months 34 and 66 (P=0.004). Conclusion: Perioperative and early postoperative event-free survival rates were similar in all three methods. By the beginning of the 34th month, the only CABG group has been negatively separated due to neurological events. In the choice of methodology, “most threatened organ priority’’ was considered as clinical parameter.
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spelling Coexisting Coronary and Carotid Artery Disease: What We Did, What HappenedCoronary Artery BypassCarotid EndarterectomyCarotid ArteriesTransient Ischemic AttackProgression-Free SurvivalMyocardial InfarctationStrokeABSTRACT Introduction: There is no complete consensus on the three surgical methods and long-term consequences for coexisting coronary and carotid artery disease. We retrospectively evaluated the surgical results in this high-risk group in our clinic for a decade. Methods: Between 2005 and 2015, 196 patients were treated for combined carotid and coronary artery disease. A total of 50 patients were operated on with the staged method, 40 of which had carotid endarterectomy (CEA) priority, and 10 had coronary artery bypass grafting (CABG) priority. CABG and CEA were simultaneously performed in 82 patients; and in 64 asymptomatic patients with unilateral carotid artery lesions and stenosis over 70%, only CABG was done (64 patients). Results were evaluated by uni-/multivariate analyses for perioperative, early, and late postoperative data. Results: In the staged group, interval between the operations was 2.82±0.74 months. Perioperative and early postoperative (30 days) parameters did not differ between groups (P-value < 0.05). Postoperative follow-up time was averaged 94.9±38.3 months. Postoperative events were examined in three groups as (A) deaths (all cause), (B) cardiovascular events (non-fatal myocardial infarction, recurrent angina, congestive heart failure, palpitation), and (C) fatal neurological events (amaurosis fugax, transient ischemic attack, and stroke). When group C events were excluded, event-free actuarial survival rates were similar in all three methods (P=0.740). Actuarial survival rate was significantly different when all events were included (P=0.027). Neurological events increased markedly between months 34 and 66 (P=0.004). Conclusion: Perioperative and early postoperative event-free survival rates were similar in all three methods. By the beginning of the 34th month, the only CABG group has been negatively separated due to neurological events. In the choice of methodology, “most threatened organ priority’’ was considered as clinical parameter.Sociedade Brasileira de Cirurgia Cardiovascular2022-10-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000500648Brazilian Journal of Cardiovascular Surgery v.37 n.5 2022reponame:Brazilian Journal of Cardiovascular Surgery (Online)instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)instacron:SBCCV10.21470/1678-9741-2021-0127info:eu-repo/semantics/openAccessGüney,Mehmet RaşitGüler,ErhanAlbay,ErkanKehlibar,TamerYilmaz,MehmetKetenci,Bülendeng2022-11-10T00:00:00Zoai:scielo:S0102-76382022000500648Revistahttp://www.rbccv.org.br/https://old.scielo.br/oai/scielo-oai.php||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br1678-97410102-7638opendoar:2022-11-10T00:00Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)false
dc.title.none.fl_str_mv Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
title Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
spellingShingle Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
Güney,Mehmet Raşit
Coronary Artery Bypass
Carotid Endarterectomy
Carotid Arteries
Transient Ischemic Attack
Progression-Free Survival
Myocardial Infarctation
Stroke
title_short Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
title_full Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
title_fullStr Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
title_full_unstemmed Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
title_sort Coexisting Coronary and Carotid Artery Disease: What We Did, What Happened
author Güney,Mehmet Raşit
author_facet Güney,Mehmet Raşit
Güler,Erhan
Albay,Erkan
Kehlibar,Tamer
Yilmaz,Mehmet
Ketenci,Bülend
author_role author
author2 Güler,Erhan
Albay,Erkan
Kehlibar,Tamer
Yilmaz,Mehmet
Ketenci,Bülend
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Güney,Mehmet Raşit
Güler,Erhan
Albay,Erkan
Kehlibar,Tamer
Yilmaz,Mehmet
Ketenci,Bülend
dc.subject.por.fl_str_mv Coronary Artery Bypass
Carotid Endarterectomy
Carotid Arteries
Transient Ischemic Attack
Progression-Free Survival
Myocardial Infarctation
Stroke
topic Coronary Artery Bypass
Carotid Endarterectomy
Carotid Arteries
Transient Ischemic Attack
Progression-Free Survival
Myocardial Infarctation
Stroke
description ABSTRACT Introduction: There is no complete consensus on the three surgical methods and long-term consequences for coexisting coronary and carotid artery disease. We retrospectively evaluated the surgical results in this high-risk group in our clinic for a decade. Methods: Between 2005 and 2015, 196 patients were treated for combined carotid and coronary artery disease. A total of 50 patients were operated on with the staged method, 40 of which had carotid endarterectomy (CEA) priority, and 10 had coronary artery bypass grafting (CABG) priority. CABG and CEA were simultaneously performed in 82 patients; and in 64 asymptomatic patients with unilateral carotid artery lesions and stenosis over 70%, only CABG was done (64 patients). Results were evaluated by uni-/multivariate analyses for perioperative, early, and late postoperative data. Results: In the staged group, interval between the operations was 2.82±0.74 months. Perioperative and early postoperative (30 days) parameters did not differ between groups (P-value < 0.05). Postoperative follow-up time was averaged 94.9±38.3 months. Postoperative events were examined in three groups as (A) deaths (all cause), (B) cardiovascular events (non-fatal myocardial infarction, recurrent angina, congestive heart failure, palpitation), and (C) fatal neurological events (amaurosis fugax, transient ischemic attack, and stroke). When group C events were excluded, event-free actuarial survival rates were similar in all three methods (P=0.740). Actuarial survival rate was significantly different when all events were included (P=0.027). Neurological events increased markedly between months 34 and 66 (P=0.004). Conclusion: Perioperative and early postoperative event-free survival rates were similar in all three methods. By the beginning of the 34th month, the only CABG group has been negatively separated due to neurological events. In the choice of methodology, “most threatened organ priority’’ was considered as clinical parameter.
publishDate 2022
dc.date.none.fl_str_mv 2022-10-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000500648
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382022000500648
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.21470/1678-9741-2021-0127
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
publisher.none.fl_str_mv Sociedade Brasileira de Cirurgia Cardiovascular
dc.source.none.fl_str_mv Brazilian Journal of Cardiovascular Surgery v.37 n.5 2022
reponame:Brazilian Journal of Cardiovascular Surgery (Online)
instname:Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron:SBCCV
instname_str Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
instacron_str SBCCV
institution SBCCV
reponame_str Brazilian Journal of Cardiovascular Surgery (Online)
collection Brazilian Journal of Cardiovascular Surgery (Online)
repository.name.fl_str_mv Brazilian Journal of Cardiovascular Surgery (Online) - Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV)
repository.mail.fl_str_mv ||rosangela.monteiro@incor.usp.br|| domingo@braile.com.br|| brandau@braile.com.br
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