Journal of Vascular Surgery
Volume 37, Issue 1 , Pages 32-39 , January 2003

Multistate population-based outcomes of combined carotid endarterectomy and coronary artery bypass

Presented at the Fiftieth Annual Meeting of the American Association for Vascular Surgery, Boston, Mass, Jun 9-12, 2002.

  • Kellie R. Brown, MD

      Affiliations

    • University of Chicago Robert Wood Johnson Clinical Scholars Progam Iowa City, Iowa
  • ,
  • Timothy F. Kresowik, MD

      Affiliations

    • Division of Vascular Surgery, University of Iowa Iowa City, Iowa
    • Iowa Foundation for Medical Care. Iowa City, Iowa
  • ,
  • Marshall H. Chin, MD, MPH

      Affiliations

    • University of Chicago Robert Wood Johnson Clinical Scholars Progam Iowa City, Iowa
    • Iowa Foundation for Medical Care. Iowa City, Iowa
  • ,
  • Rebecca A. Kresowik, BLS

      Affiliations

    • Iowa Foundation for Medical Care. Iowa City, Iowa
  • ,
  • Sherry L. Grund, RN

      Affiliations

    • Iowa Foundation for Medical Care. Iowa City, Iowa
  • ,
  • Marc E. Hendel, MS

      Affiliations

    • Iowa Foundation for Medical Care. Iowa City, Iowa

Received 18 June 2002 ,Accepted 26 August 2002.

References 

  1. Hertzer NR, Young JR, Beven EG, Graor RA, O'Hara PJ, Ruschhaupt WF, et al.  Coronary angiography in 506 patients with extracranial cerebrovascular disease. Arch Intern Med. 1985;145:849–852
  2. Cohen SN, Hobson RW, Weiss DG, Chimowitz M. Death associated with asymptomatic carotid artery stenosis: long-term clinical evaluation. VA Cooperative Study 167 Group. J Vasc Surg. 1993;18:1002–1009
  3. Estes JM, Guadagnoli E, Wolf R, LoGerfo FW, Whittemore AD. The impact of cardiac comorbidity after carotid endarterectomy. J Vasc Surg. 1998;28:577–584
  4. Goldstein LB, McCrory DC, Landsman PB, Samsa GP, Ancukiewicz M, Oddone EZ, et al.  Multicenter review of preoperative risk factors for carotid endarterectomy in patients with ipsilateral symptoms. Stroke. 1994;25:1116–1121
  5. Schwartz LB, Bridgman AH, Kieffer RW, Wilcox RA, McCann RL, Tawil MP, et al.  Asymptomatic carotid artery stenosis and stroke in patients undergoing cardiopulmonary bypass. J Vasc Surg. 1995;21:146–153
  6. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators. N Engl J Med. 1991;325:445–453
  7. Executive Committee for the Asymptomatic Carotid Atherosclerosis Study. Endarterectomy for asymptomatic carotid artery stenosis. JAMA. 1995;273:1421–1428
  8. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kennedy JW, et al.  Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994;344:563–570
  9. Akins CW, Moncure AC, Daggett WM, Cambria RP, Hilgenberg AD, Torchiana DF, et al.  Safety and efficacy of concomitant carotid and coronary artery operations. Ann Thorac Surg. 1995;60:311–317
  10. Chang BB, Carling C, Shah DM, Paty PSK, Leather RP. Carotid endarterectomy can be safely performed with acceptable mortality and morbidity in patients requiring coronary artery bypass grafts. Am J Surg. 1994;168:94–96
  11. Daily PO, Freeman RK, Dembitsky WP, Adamson RM, Moreno-Cabral RJ, Marcus S, et al.  Cost reduction by combined carotid endarterectomy and coronary artery bypass grafting. J Thorac Cardiovasc Surg. 1996;111:1185–1192
  12. Darling RC, Dylewski M, Chang BB, Paty PS, Kreienberg PB, Lloyd WE, et al.  Combined carotid endarterectomy and coronary artery bypass grafting does not increase the risk of perioperative stroke. Cardiovasc Surg. 1998;6:448–452
  13. Evagelopoulos N, Trenz MT, Beckmann A, Krian A. Simultaneous carotid endarterectomy and coronary artery bypass grafting in 313 patients. Cardiovasc Surg. 2000;8:31–40
  14. Hertzer NR, Loop FD, Beven EG, O'Hara PJ, Krajewski LP. Surgical staging for simultaneous coronary and carotid disease: a study including prospective randomization. J Vasc Surg. 1989;9:455–463
  15. Khaitan L, Sutter FP, Goldman SM, Chamogeorgakis T, Wertan MA, Priest BP, et al.  Simultaneous carotid endarterectomy and coronary revascularization. Ann Thorac Surg. 2000;69:421–424
  16. Minami K, Fukahara K, Boethig D, Bairaktaris A, Fritzsche D, Koerfer R. Long-term results of simultaneous carotid endarterectomy and myocardial revascularization with cardiopulmonary bypass used for both procedures. J Thorac Cardiovasc Surg. 2000;119:764–773
  17. Plestis KA, Ke S, Jiang ZD, Howell JF. Combined carotid endarterectomy and coronary artery bypass: immediate and long-term results. Ann Vasc Surg. 1999;13:84–92
  18. Rizzo RJ, Whittemore AD, Couper GS, Donaldson MC, Aranki SF, Collins JJ, et al.  Combined carotid and coronary revascularization: the preferred approach to the severe vasculopath. Ann Thorac Surg. 1992;54:1099–1108
  19. Snider F, Rossi M, Manni R, Modugno P, Glieca F, Scapigliati A, et al.  Combined surgery for cardiac and carotid disease: management and results of a rational approach. Eur J Vasc Endovasc Surg. 2000;20:523–527
  20. Takach TJ, Reul GJ, Cooley DA, Duncan JM, Ott DA, Livesay JJ, et al.  Is an integrated approach warranted for concomitant carotid and coronary artery disease?. Ann Thorac Surg. 1997;64:16–22
  21. Trachiotis GD, Pfister AJ. Management strategy for simultaneous carotid endarterectomy and coronary revascularization. Ann Thorac Surg. 1997;64:1013–1018
  22. Kresowik TF, Bratzler D, Karp HR, Hemann RA, Hendel ME, Grund SL, et al.  Multistate utilization, processes, and outcomes of carotid endarterectomy. J Vasc Surg. 2001;33:227–235
  23. Bass A, Krupski WC, Dilley RB, Bernstein EF. Combined carotid endarterectomy and coronary artery revascularization: a sobering review. Isr J Med Sci. 1992;28:27–32
  24. Hertzer NR, O'Hara PJ, Mascha EJ, Krajewski LP, Sullivan TM, Beven EG. Early outcome assessment for 2228 consecutive carotid endarterectomy procedures: the Cleveland Clinic experience from 1989 to 1995. J Vasc Surg. 1997;26:1–10
  25. Borger MA, Fremes SE, Weisel RD, Cohen G, Rao V, Lindsay TF, et al.  Coronary bypass and carotid endarterectomy: does a combined approach increase risk? A metaanalysis. Ann Thorac Surg. 1999;68:14–20
  26. John R, Choudhri AF, Weinberg AD, Ting W, Rose EA, Smith CR, et al.  Multicenter review of preoperative risk factors for stroke after coronary artery bypass grafting. Ann Thorac Surg. 2000;69:30–36
  27. Saimanen EI. Perioperative stroke in coronary artery bypass surgery. Analysis of risk factors. Scand Cardiovasc J. 2000;34:41–45
  28. Bilfinger TV, Reda H, Giron F, Seifert FC, Ricotta JJ. Coronary and carotid operations under prospective standardized conditions: incidence and outcome. Ann Thorac Surg. 2000;69:1792–1798
  29. Roach GW, Kanchuger M, Mangano CM, Newman M, Nussmeier N, Wolman R, et al.  Adverse cerebral outcomes after coronary bypass surgery. Multicenter Study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med. 1996;335:1857–1863
  30. McCrory DC, Goldstein LB, Samsa GP, Oddone EZ, Landsman PB, Moore WS, et al.  Predicting complications of carotid endarterectomy. Stroke. 1993;24:1285–1291
  31. Ricotta JJ, Faggioli GL, Castilone A, Hassett JM. Risk factors for stroke after cardiac surgery: Buffalo Cardiac-Cerebral Study Group. J Vasc Surg. 1995;21:359–363
  32. Sadeghi N, Sadeghi S, Mood ZA, Karimi A. Determinants of operative mortality following primary coronary artery bypass surgery. Eur J Cardiothorac Surg. 2002;21:187–192
  33. Craddock D, Iyer VS, Russell WJ. Factors influencing mortality and myocardial infarction after coronary artery bypass grafting. Curr Opin Cardiol. 1994;9:664–669
  34. Hogue CW, Barzilai B, Pieper KS, Coombs LP, DeLong ER, Kouchoukos NT, et al.  Sex differences in neurological outcomes and mortality after cardiac surgery. A society of thoracic surgery national database report. Circulation. 2001;103:2133–2137

 Supported by the Iowa Foundation for Medical Care and the Robert Wood Johnson Clinical Scholars Program.

☆☆ Analyses on which this publication is based were performed under Contract Number 500-99-IA03, entitled “Utilization and Quality Control Peer Review Organization for the State of Iowa,” sponsored by the Centers for Medicare and Medicaid Services, Department of Health and Human Services. Content of this publication does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organization imply endorsement by the US Government.

 The author assumes full responsibility for the accuracy and completeness of the ideas presented. This article is a direct result of the Health Care Quality Improvement Program initiated by the Centers for Medicare and Medicaid Services, which has encouraged identification of quality improvement projects derived from analysis of patterns of care and therefore required no special funding on the part of this contractor. Ideas and contributions to the author concerning experience in engaging with issues presented are welcomed.

★★ Competition of interest: nil.

 Reprint requests: Kellie R. Brown, MD, 9200 W. Wisconsin Ave, Milwaukee, WI 53226 (e-mail: krbrown@mcw.edu).

♢♢ 0741-5214/2003/$30.00 + 0

PII: S0741-5214(02)75201-4

doi: 10.1067/mva.2003.60

Journal of Vascular Surgery
Volume 37, Issue 1 , Pages 32-39 , January 2003