TY  - BOOK
AU  - Jonnalagadda, Anil K
TI  - Synchronous Carotid Endarterectomy and Coronary Artery Bypass Graft versus Staged Carotid Artery Stenting and Coronary Artery Bypass Graft for Patients with Concomitant Severe Coronary and Carotid Stenosis: A Systematic Review and Meta-analysis
SN  - 0890-5096
PY  - 2020///
KW  - *Carotid Stenosis/su [Surgery]
KW  - *Coronary Artery Bypass
KW  - *Coronary Stenosis/su [Surgery]
KW  - *Endarterectomy, Carotid
KW  - Aged
KW  - Carotid Stenosis/dg [Diagnostic Imaging]
KW  - Carotid Stenosis/mo [Mortality]
KW  - Coronary Artery Bypass/ae [Adverse Effects]
KW  - Coronary Artery Bypass/mo [Mortality]
KW  - Coronary Stenosis/dg [Diagnostic Imaging]
KW  - Coronary Stenosis/mo [Mortality]
KW  - Endarterectomy, Carotid/ae [Adverse Effects]
KW  - Endarterectomy, Carotid/mo [Mortality]
KW  - Female
KW  - Humans
KW  - Ischemic Attack, Transient/mo [Mortality]
KW  - Male
KW  - Myocardial Infarction/mo [Mortality]
KW  - Risk Assessment
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Stroke/mo [Mortality]
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Washington Hospital Center
KW  - Medicine/General Internal Medicine
KW  - Journal Article
KW  - Review
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: Due to the systemic nature of atherosclerosis, medium and large arteries at different sites are commonly simultaneously affected. As a result, severe coronary artery disease (CAD) requiring coronary artery bypass graft (CABG) frequently coexists with significant carotid stenosis that warrants revascularization; CONCLUSIONS: The current meta-analysis did not detect statistically significant differences in the rates of peri-operative stroke, TIA and MI between the groups. However, patients in the simultaneous CEA and CABG group had a significantly higher risk of 30-day mortality. Future randomized trials or prospective cohorts are needed to validate our results. Copyright (c) 2019 Elsevier Inc. All rights reserved; METHODS: This study was performed according to the PRISMA guidelines. Eligible studies were identified through a search of PubMed, Scopus and Cochrane until July, 2018. A meta-analysis was conducted with the use of a random effects model. The I-square statistic was used to assess heterogeneity; OBJECTIVE: To compare synchronous carotid endarterectomy (CEA) and CABG vs. staged carotid artery stenting (CAS) and CABG for patients with concomitant CAD and carotid artery stenosis in terms of peri-operative (30-day) outcomes; RESULTS: Five studies comprising 16,712 patients were included in this meta-analysis. Peri-operative stroke (odds ratio (OR): 0.84; 95% confidence interval (CI): 0.43- 1.64; I2= 39.1%), transient ischemic attack (TIA) (OR: 0.32; 95% CI: 0.04- 2.67; I2= 27.6%) and myocardial infarction (MI) rates (OR: 0.56; 95% CI: 0.08- 3.85; I2= 68.9%) were similar between the two groups. However, patients who underwent simultaneous CEA and CABG were at a statistically significant higher risk for peri-operative mortality (OR: 1.80; 95% CI: 1.05- 3.06; I2= 0.0%)
UR  - https://dx.doi.org/10.1016/j.avsg.2019.06.018
ER  -