Ren Shiyan, Liu Peng, Ma Guolin, Wang Fei, Qian Songyi, Fan Xueqiang
Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China.
Ann Thorac Cardiovasc Surg. 2012;18(3):228-35. doi: 10.5761/atcs.oa.12.01928.
To compare the effect of combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) with solely CEA.
During a five-year period ending December 2009, 25 consecutive patients received concomitant CEA and CABG, whereas, 62 consecutive patients underwent only CEA. They were followed at the median for 64.5 months. The Kaplan-Meier method was used to evaluate the survival rate of patients in both groups.
There was no significant difference in terms of age, proportion of gender, risk factors of coronary artery disease and carotid artery stenosis. The degree of carotid artery stenosis was identical in both study groups. One patient in CEA/CABG group had 60% stenosis of carotid artery with ulcerative plaque. There was no early death in the short postoperative period. Restenosis was found on ultrasonography in 4 patients in the CEA/CABG group, and 12 patients in the CEA group; no statistical difference was found between both groups (P = 0.952). The intubation time, ICU stay, and hospital stay in CEA/CABG group were longer than in solely CEA group (P <0.001). The median duration of follow-up was 64.5 months (IQR 24-84 months). The survival rate was 88 %(22/25) in CEA/CABG group and 80.6 %(50/62) in CEA group, product-limit analysis showed that there was no significant difference in survival rates between two groups (P >0.05).
concomitant carotid endarterectomy and CABG can be safely performed, it could prevent stroke and would not increase the overall risk of surgery.
比较颈动脉内膜切除术（CEA）联合冠状动脉旁路移植术（CABG）与单纯CEA的效果。
在截至2009年12月的五年期间，25例连续患者接受了CEA联合CABG手术，而62例连续患者仅接受了CEA手术。对他们进行了中位时间为64.5个月的随访。采用Kaplan-Meier法评估两组患者的生存率。
两组在年龄、性别比例、冠状动脉疾病危险因素和颈动脉狭窄方面无显著差异。两个研究组的颈动脉狭窄程度相同。CEA/CABG组有1例患者颈动脉狭窄60%，伴有溃疡性斑块。术后短期内无早期死亡病例。CEA/CABG组超声检查发现4例再狭窄，CEA组发现12例再狭窄；两组间无统计学差异（P = 0.952）。CEA/CABG组的插管时间、ICU停留时间和住院时间均长于单纯CEA组（P <0.001）。中位随访时间为64.5个月（IQR 24 - 84个月）。CEA/CABG组的生存率为88%（22/25），CEA组为80.6%（50/62），乘积限分析显示两组生存率无显著差异（P >0.05）。
CEA联合CABG手术可安全进行，可预防中风且不会增加手术总体风险。
