Carotid and noncoronary operations: simultaneous, staged, and delayed.

Carotid operation has been shown to be effective in the control of stroke in patients with asymptomatic bruits and transient ischemic attacks (TIAs). This procedure also has been demonstrated to be effective in the control of this disorder when performed simultaneously with coronary artery bypass operations. Similar studies have been reported in patients submitted to other operations. This is a study of 130 patients who had first carotid artery operation and then 215 noncoronary operations. Simultaneous operation was performed in 42, staged in 40, and both in eight patients. In addition, 40 patients were submitted to operation over 3 months after carotid operations. TIAs and one stroke occurred after carotid operation but no deaths. The cumulative results were eight TIAs and three strokes. Only one patient died of stroke. Results were similar in all groups, and therefore it is thought that carotid operation reduces the incidence of stroke following these operations and that simultaneous procedures are feasible in the majority of cases on a selective basis. Moreover, carotid operation seems to protect patients from stroke after operation performed months later.