Fourny J, Limet R
Acta Chir Belg. 1979 Mar-Apr;78(2):121-5.
The association of a coronary insufficiency and a significant stenosis of the carotid trunks brings up a difficult problem of operative strategy. In a series of 142 patients operated by an aortocoronary vein graft 5 presented a bilateral carotid stenosis, of which two had a history of transient ischemic accidents. These were operated either in sequence: carotid then coronary, or by a simultaneous procedure. In conclusion it appears the planning of surgical procedures in cases of such combined vascular insufficiencies depends on the relative severity of both lesions, and in a case of unstable angina a simultaneous carotid-coronary operation is warranted.
冠状动脉供血不足与颈动脉主干严重狭窄并存会带来手术策略方面的难题。在142例行主动脉冠状动脉静脉搭桥手术的患者中,有5例存在双侧颈动脉狭窄,其中2例有短暂性缺血发作史。这些患者要么按顺序进行手术:先做颈动脉手术,再做冠状动脉手术,要么同时进行手术。总之,对于此类合并血管供血不足的病例,手术方案的制定取决于两种病变的相对严重程度,对于不稳定型心绞痛患者,同时进行颈动脉 - 冠状动脉手术是可行的。