Naslov
Concomitant carotid and coronary artery disease: Indications for simultaneous treatment and operative strategy

Autori
Petrunić, Mladen ; Biočina, Bojan ; Gošev, Igor ; Meštrović, Tomislav ; Halužan, Damir

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
3rd Central european congress of surgery, Norman Barrett Symposium & 5th Croatian congress of surgery with international participation : abstracts ; u: European surgery 42 (2010) (S235) / Župančić, Božidar - Beč : Springer, 2010, 92-93

Skup
Central European Congress of surgery (3 ; 2010)

Mjesto i datum
Dubrovnik, Hrvatska, 28.04.2010. - 01.05.2010

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
concomitant surgery ; carotid disease ; coronary artery disease ; carotid endarterectomy ; coronary artery bypass grafting

Sažetak
The reports on incidence of the concomitant carotid and coronary artery disease vary depending on patient selection, screening protocols, and criteria utilized. In one large series of patients undergoing carotid endarterectomy (CE), the incidence of severe coronary artery disease (CAD) revealed up to 35%. On the other hand, according to the different reports, the incidence of severe carotid stenosis in patients undergoing coronary artery bypass grafting (CABG) varies from 5% to 12%. The management of patients with such complex pathology is still debated and there are no standard treatment protocols supported by a substantial number of prospective randomized trials. Three basic treatment protocols are currently in use: 1. Staged strategy: CE 1st, CABG 2nd ; 2. Reversed staged strategy: CABG 1st, CE 2nd ; 3. Simultaneous CE and CABG. Results. The results of themeta-analysis showed that the risk of myocardial infarction (MI) and death was increased in the ‘staged strategy’’ group, while the stroke risk was significantly higher in the ‘‘reversed staged’’ group. Conclusions. Based on the results of some case series of patients, it would appear that simultaneous CE and CABG produce the least stroke=death rate in a patient with severe concomitant pathology. Considering the rationale for such approach, we present the indications, operative strategy and results from our Institution.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA