Efficacy of carotid endarterectomy and stenting in simultaneous carotid and coronary artery revascularization

Objective To explore the efficacy of carotid endarterectomy (CEA) and stenting in simultaneous carotid and coronary artery revascularization. Methods Retrospective analysis was performed for the clinical data of 38 patients with simultaneous carotid and coronary artery revascularization in China-Japan Friendship Hospital from January 2008 to December 2014. The clinical characteristics, imageological examination, treatment and prognosis were reviewed. According to the technique of carotid revascularization, the patients were classified into CEA group (31 cases) and carotid artery stent (CAS) group (7 cases). The relevant clinical variables were analyzed and compared between two groups. Results The mean operative time of CEA and CAS groups were (294.68±48.18)min and (260.71±44.94)min, respectively. The mean blood losses of CEA and CAS groups were (770.97±344.67)ml and (628.57±236.04)ml, respectively. The differences of operative time and blood loss between two groups were not significant. Three minor strokes, 4 transient ischemia attacks (TIA), 2 pulmonary infections, and 3 recurrent laryngeal nerve injuries were observed in CEA group. One TIA and 1 re-thoracotomy for hemostasis were occurred in CAS group. No peri-operative myocardial infarction and death were occurred in both groups. Conclusions Both carotid endarterectomy and carotid stenting were safe and reliable in simultaneous carotid and coronary artery revascularization. The proper technique of carotid artery revascularization should be chosen according to the characteristics of each patient. Key words: Endarterectomy, carotid; Stents; Carotid arteries/SU; Coronary vessels/SU