Carotid and Cerebrovascular Disease

Staged Versus Synchronous Carotid Endarterectomy and Coronary Artery Bypass Grafting: Analysis of 10-Year Nationwide Outcomes

Gopaldas RR, Chu D, Dao TK, et al (Univ of Missouri-Columbia School of Medicine; Baylor College of Medicine, Houston, TX; The Michael E. DeBakey Veterans Affairs Med Ctr, Houston, TX; et al) Ann Thorac Surg 91:1323–1329, 2011^§

Abstract

Background

The timing of operative interventions for patients with concurrent carotid and coronary artery disease is controversial. We evaluated nationwide data regarding staged or synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) and compared the two approaches’ outcome profiles.

Methods

From Nationwide Inpatient Sample database 1998 to 2007, we identified 6,153 (28.9%) patients who underwent CEA before or after CABG during the same hospital admission but not on the same day (STAGED) and 16,639 patients who underwent both procedures on the same day (SYNC). Hierarchic multivariable regression was used to assess the independent effect of operative strategy on mortality, neurologic and overall complications, and charges.

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