Gayet J L, Devolfe C, Girard C
Ann Cardiol Angeiol (Paris). 1985 May;34(5):347-52.
Coronary insufficiency is responsible for part of the peri-operative mortality of carotid surgery and it is by far the principal long term cause of death. Conversely, cerebral vascular accidents due to extra-cranial carotid stenosis compromise the results of myocardial revascularisation operations less than coronary insufficiency itself. Patients who require double surgery can be recognised on the basis of the clinical findings. The essential indication for this surgery is double clinical instability. Apart from these patients, the group of patients at high risk still need to be defined. Strictly preventative coronary and carotid surgery seem to be less justified, particularly as the currently available prophylactic measures and medical treatments appear to achieve a relative improvement in the long term prognosis of these patients with multiple vessel disease.
冠状动脉供血不足是颈动脉手术围手术期死亡的部分原因，且是迄今为止主要的长期死亡原因。相反，颅外颈动脉狭窄所致的脑血管意外对心肌血运重建手术结果的影响小于冠状动脉供血不足本身。需要进行双重手术的患者可根据临床发现来识别。这种手术的基本指征是双重临床不稳定。除了这些患者外，高危患者群体仍有待界定。严格的预防性冠状动脉和颈动脉手术似乎不太合理，尤其是因为目前可用的预防措施和药物治疗似乎能相对改善这些患有多支血管疾病患者的长期预后。
