Safe to Double-Up Stenting Carotid, Coronary Arteries

Posted by: admin on: December 16, 2011

Peripheral artery disease with the affection of coronary arteries and carotid arteries invariably end up in surgical treatment. But there is an alternate procedure for those in high risks. Read on to know more.

Team@CMHF

Tomai and colleagues noted that percutaneous stenting has recently proved to be an acceptable alternative to carotid endarterectomy and CABG in high-surgical risk patients.
Furthermore, the presence of obstructive carotid disease is associated with a significant increase in death and stroke in patients undergoing CABG, they wrote.
At long-term follow up, patients with previous cardiovascular disease had significantly higher rates of major cardiac and cerebrovascular events than did patients with a first clinical episode

They noted a high incidence of death, stroke, or MI (between 7% and 14%) using a variety of therapeutic strategies in this patient population, including coronary artery bypass graft (CABG) alone, or CABG associated with staged or simultaneous carotid endarterectomy or carotid artery stenting.

Tomai and colleagues noted that percutaneous stenting has recently proved to be an acceptable alternative to carotid endarterectomy and CABG in high-surgical risk patients.
Furthermore, the presence of obstructive carotid disease is associated with a significant increase in death and stroke in patients undergoing CABG, they wrote.
Multicenter study demonstrates that in patients with coronary artery disease and concomitant carotid obstructive disease, a combined percutaneous revascularization treatment yields good immediate and long-term results,” Tomai and colleagues concluded.

They noted that this is the largest available series of its kind and “reinforces the concept of feasibility demonstrated in previous small series.” It also compares favorably to similar populations treated surgically or with a hybrid approach
The authors noted that a limitation to the study is that the results may not be extrapolated to less experienced centers. In addition, the results cannot be compared to randomized clinical trials, and the lack of systematic performance of diffusion-weighted MRI “might underestimate the incidence of clinically silent cerebral infarction after carotid artery stenting.”

Ref: http://www.medpagetoday.com/Cardiology/PeripheralArteryDisease/26542?utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC&userid=333280

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