Should patients with concomitant coronary and carotid artery disease undergo simultaneous carotid endarterectomy or stenting for severe asymptomatic carotid artery stenosis? A review of the literature

Abstract

Objectives: The incidence of significant carotid artery disease in patients undergoing coronary artery bypass grafting (CABG) ranges from 2.8 – 22%. Whether simultaneous or delayed carotid endarterectomy (CEA) or stenting (CAS) is recommended for asymptomatic severe carotid disease in patients requiring CABG remains controversial. Current guidelines recommendations were based on previous meta-analyses, that documented no significant differences in outcomes for delayed or simultaneous approaches, while acknowledging the requirement for randomized controlled trials (RCTs).