Surgical management of synchronous carotid and coronary artery disease.

To determine the safest method of treating simultaneously occurring coronary artery disease and asymptomatic carotid stenosis, patients were randomly assigned to either combined operation or a staged procedure with coronary artery surgery done first, followed by carotid endarterectomy. In the initial 70 patients, there were two strokes (5.9%) and two deaths (5.9%) in the combined group and four strokes (11%) and one death (2.8%) in the group with coronary artery surgery performed first.