European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · Apr 2009
Review Meta AnalysisA systematic review and meta-analysis of 30-day outcomes following staged carotid artery stenting and coronary bypass.
To determine the overall operative risk of cardiovascular events in patients with combined cardiac and carotid artery disease undergoing staged carotid artery stenting (CAS) and coronary artery bypass grafting (CABG). ⋯ In a cohort of predominantly asymptomatic patients with unilateral carotid disease, the 30-day risk of death/any stroke was 9.1%. These data are comparable to previous systematic reviews evaluating the roles of staged and synchronous carotid endarterectomy (CEA) plus CABG, and suggest that staged CAS plus CABG is an attractive and less invasive alternative to CEA plus CABG. However, it remains questionable whether the observed 9% risks can be justified in any asymptomatic patient with unilateral carotid disease.