Best To Split Up Carotid Opening, Heart Surgery

Mon, 08/05/2013 - 9:18am
Chris Kaiser

Over the long term, the best of three operative approaches for patients with severe carotid and coronary artery disease (CAD) also happens to be the one that is least available to them, a retrospective study suggested.

Patients who underwent carotid artery stenting followed a few weeks later by open heart surgery (a "staged" procedure) had a lower risk of the composite primary endpoint of all-cause death, stroke, or myocardial infarction (MI) than those who underwent staged carotid endarterectomy followed by open heart surgery (CEA-OHS) or those who had CEA-OHS performed on the same day (a "combined" procedure).

The relative reduced risk over a period longer than 1 year was 67% for staged stenting compared with staged endarterectomy, and 65% for staged stenting versus the combined procedure, according to Mehdi H. Shishehbor, DO, MPH, PhD, director of endovascular services at the Cleveland Clinic, and colleagues.

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