Carotid artery stenting followed by open heart surgery in 323 patients: One‐year results and influencing factors

OBJECTIVES: The purpose of this study was to evaluate 1-year results and influencing factors of carotid artery stenting (CAS) before open heart surgery (OHS). BACKGROUND: Currently, the clinical outcomes and influencing factors of CAS followed by OHS still remain controversial. METHODS: Three hundred twenty-three consecutive patients scheduled for CAS and OHS were enrolled in this study. The primary endpoint was a composite of major stroke, myocardial infarction, or death within 1 year after CAS. RESULTS: The incidence of the primary endpoint was 5.6% (18/323). The Cox regression analysis revealed that an interval of ≤5 days between CAS and OHS (HR, 4.85, 95% CI, 1.87-12.58; P = 0.001), congestive heart failure (HR, 4.08, 95% CI, 1.45-11.51; P = 0.008), and renal insufficiency (HR, 4.56, 95% CI, 1.28-16.32; P = 0.020) could independently predict the incidence of the primary endpoint. The rate of the primary endpoint from CAS to 30 days after OHS was 4.6% (15/323). An interval of ≤5 days between CAS and OHS (OR, 4.51, 95% CI, 1.52-13.36; P = 0.007) and congestive heart failure (OR, 5.32, 95% CI, 1.63-17.43; P = 0.006) were identified as independent risk factors for the primary endpoint rate from CAS to 30 days after OHS by logistic regression analysis. CONCLUSIONS: CAS followed by OHS is a safe and effective treatment for patients with concomitant carotid and cardiac disease within 1-year follow up. The interval between CAS and OHS, congestive heart failure, and renal insufficiency could obviously influence the 1-year results.