Methods
One hundred fifty patients with asymptomatic carotid artery disease ≥70% according to the NASCET criteria (NASCET, 1991) and stable multivessel coronary artery disease scheduled for coronary artery bypass grafting (CABG) were enrolled in our study. Patients with critical left main disease, unstable angina, recent acute myocardial infarction, EF <40%, chronic renal failure or severe renal impairment, recent stroke, or TIA within the last 6 months were excluded from our study. Demographic data of the studied group was as follows: mean age, 64±4 years; gender, 108 (72%) male, 42 (28%) female; diabetes, 112 (74%); dyslipidemic, 122 (81%); hypertension, 118 (78%); previous myocardial infarction, 98 (65%); previous stroke >6 months, 48 (32%); contralateral carotid lesion ≥70%, 71 (47%). In all patients, carotid duplex was done pre- and post-CAS; all patients received aggressive anti-ischemic medical treatment with special emphasis on beta blockers with resting target heart rate ≤60 beat/min; 80 mg/day atorvastatin was tolerated in most of the cases, 75 mg/day clopidogrel, 150 mg/day aspirin. In patients with bilateral stenosis, a multistage procedure was performed with a mean delay of 5±2 days. All cases were performed via transfemoral approach, and filter wire protection devices were used. CABG surgery was performed after 35±7 days with both off- and on-pump techniques applied according to surgeon’s preference.
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