Carotid Artery Stenting prior to Cardiac Surgery

摘要: This thesis describes the strategy of management and treatment patients with concomitant significant carotid coronary artery disease. The short long term outcome a single centre experience is reported compared general common practise. author conducted different observational trials in order to provide more information justify institutional policy. More particularly, use embolic protection devices asymptomatic questioned, optimal antiplatelet therapy investigated CT perfusion better understand individual cerebral hemodynamics examined. Patients stenosis undergoing CAS-CABG have decreased stroke death rate those isolated CABG or CEA-CABG. CAS may be safer revascularization option for requiring terms postoperative prevention. In symptomatic available data are confounding, therefore preferred remains unclear, however will result incontestably higher periprocedural complication rates. Although level I evidence would ideal determine best who require combined arterial disease, design implementation multicenter randomised clinical trial has been proven impractical unrealistic. heterogeneity varying degrees disease preference intervention main limitations such trial. Nevertheless, when conceived, should compare (including on off pump surgery) CEA-CABG separately. Optimal concurrent unresolved despite extensive publications during last 30 years. only 40% 50% strokes after ipsilateral an existing lesion, one few options reduce excessive rates