Variants of surgical treatment of patients with combined pathology of coronary and carotid arteries

• Mikhaylov K.M.
• Kuznetsov D.V.
• Mikhailov M.S.
• Khokhlunov S.M.
• Kislukhin T.V.
• Ridel V.Yu.
• Polyaeva M.V.
• Shcherbakova L.A.
• Khalmetova A.A.

Abstract

Concomitant lesion of coronary and carotid arteries is not uncommon pathology in patients undergoing treatment in cardiosurgical hospitals, with a frequently arising question on staged treatment of this patient cohort.

We describe herein two clinical case reports concerning patients presenting with combined pathology of coronary and carotid arteries and admitted to the cardiosurgical department with a clinical course of unstable angina pectoris. One patient underwent staged treatment, with the first stage consisting of stenting of the internal carotid artery, followed by coronary artery bypass grafting performed several days later. The second patient was subjected to combined operation – eversion carotid endarterectomy and coronary artery bypass grafting. The interventions proved uneventful, with no complications. The patients were discharged on POD 10. Also discussed are the main clinical manifestations of combined pathology of coronary and carotid arteries, ultrasonographic and radiological peculiarities of diagnosis, as well as methods of surgical treatment.

Keywords:carotid endarterectomy; coronary artery bypass grafting; stenting of internal carotid artery; unstable angina pectoris; surgical policy

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