Abstract
To assess 30-day outcomes and the optimal interval between carotid artery stenting (CAS) and open heart surgery (OHS). Whether or not they show symptoms of carotid atherosclerosis, patients with significant carotid stenosis who underwent OHS face a high risk of perioperative stroke. Planning appropriate treatment for carotid stenosis before OHS has become an important clinical issue. From January 2005 to June 2010, 154 inpatients scheduled for CAS and OHS were recruited and followed up for 30 days after OHS. The primary end point was a composite of major stroke or neurological death. The secondary end points included a composite of major stroke, myocardial infarction (MI) or any death, minor stroke, and acute kidney injury (AKI). The incidence of the primary end point, the composite of major stroke, MI or any death, minor stroke and AKI was 3.2%, 5.8%, 2.6%, and 4.5%, respectively. Only an interval between CAS and OHS of ≤5 days could independently predict the incidence of the primary end point (OR, 14.06, 95% CI, 1.52-130.13; P=0.020). Moreover, congestive heart failure (OR, 7.07, 95% CI, 1.55-21.27; P=0.012) and an interval between CAS and OHS of ≤5 days (OR, 7.05, 95% CI, 1.58-31.40; P=0.010) were identified as independent risk factors for the composite of major stroke, MI, or any death. Our findings indicate that CAS followed by OHS is safe and feasible. More importantly, an interval between CAS and OHS of >5 days may decrease periprocedural complications, especially major stroke and neurological death.
Published Version
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