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Published in: BMC Cardiovascular Disorders 1/2020

Open Access 01-12-2020 | Stroke | Research article

Carotid endarterectomy versus conservative management of the asymptomatic carotid stenosis before coronary artery bypass grafting: a retrospective study

Authors: Mario Lescan, Mateja Andic, Oana Bartos, Christian Schlensak, Migdat Mustafi

Published in: BMC Cardiovascular Disorders | Issue 1/2020

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Abstract

Background

Our retrospective single-center study aimed to evaluate the safety of the carotid endarterectomy (CEA) in comparison to patients with untreated asymptomatic carotid stenosis ≥60% before CABG.

Methods

This single-center retrospective study included 174 patients with asymptomatic unilateral carotid stenosis treated between 2004 and 2017 with CABG. Thereof 106 patients had CEA before cardiac surgery either by a simultaneous (n = 62) or staged (n = 44) approach. Patients with untreated carotid stenosis served as control (no-CEA group; n = 68).

Results

The mean stenosis grade was higher in the CEA group (CEA 83% (±1), no-CEA 71% (±1) p < 0.0001). The overall stroke rate was 5/174 (3%) and was due to a high incidence of stroke in the no-CEA group (CEA: 0/106 (0%); No-CEA 5/68 (7%) p = 0.0083). The overall mortality was 1% and comparable between the groups (CEA: 2/106 (2%); No-CEA 0/68 (0%) p = 0.5211). Stroke related mortality was not observed. The groups were similar regarding the incidence of myocardial infarction (p = 1.0), atrial fibrillation (p = 0.1931), delirium (p = 0.2106) and IMC/ICU stay (p = 0.1542). No significant difference in the subgroup analysis was found between the simultaneous and staged approach regarding the myocardial infarction (simultaneous: 1/62 (1%); staged: 1/44 (1%); p = 1.0).

Conclusions

CEA performed as a staged procedure in local anesthesia or a simultaneous procedure in general anesthesia, may reduce the stroke risk prior to CABG.
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Metadata
Title
Carotid endarterectomy versus conservative management of the asymptomatic carotid stenosis before coronary artery bypass grafting: a retrospective study
Authors
Mario Lescan
Mateja Andic
Oana Bartos
Christian Schlensak
Migdat Mustafi
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2020
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-020-01585-z

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