Анализ результатов хирургического лечения сочетанного атеросклеротического поражения сонных и коронарных артерий

The article provides surgical treatment outcomes of combined atherosclerotic lesions of carotid and coronary arteries in 143 patients who underwent different surgical treatment tactics. The major criteria for the choice of surgical treatment stages in patient Group 1 were degree of carotid and coronary circulation lesion and severity of clinical manifestations of CAD and chronic cerebrovascular insufficiency. Surgical treatment for patient Group 2 was identified taking into account the study data of functional reserve of myocardial and cerebral perfusion. In patient Group 3 the tactics of simultaneous surgical treatment was based only on the presence of combined, hemodynamically significant atherosclerotic lesion of carotid and coronary arteries. The outcomes showed that functional evaluation of myocardial and cerebral perfusion reserve allows differentiation of high risk patients with combined atherosclerotic lesion of carotid and coronary circulation and thus contributes to the choice of the best possible surgical treatment tactics. Simultaneous surgeries are reasonable for the patients with lowered reserve of both coronary and cerebral circulation. Moreover, the risk of cerebral and cardiac postoperative complications in such patients is not higher than that after staged surgical treatment.