Why the study?
Does prophylactic or synchronous carotid endarterectomy improve outcomes in patients with asymptomatic carotid stenosis undergoing general, vascular, or CABG procedures?
Does prophylactic or synchronous carotid endarterectomy improve outcomes in patients with asymptomatic carotid stenosis undergoing general, vascular, or CABG procedures?
Prophylactic carotid endarterectomy is generally not supported before general surgery in asymptomatic patients, but synchronous CEA/CABG can be considered in select low-risk patients with severe stenosis.
Does not support routine prophylactic CEA before general surgery in asymptomatic stenosis; leaves open selective synchronous CEA/CABG in low-risk CABG candidates.
Current available data do not seem to support the strategy for carotid endarterectomy prior to surgical intervention in patients with asymptomatic carotid stenosis. However, in patients with coronary artery disease, synchronous carotid endarterectomy and coronary artery bypass grafting should be considered where there is a proven surgical risk of <3% with unilateral asymptomatic stenosis >60% or bilateral carotid stenosis >75% on the same side as the most severe stenosis. Clarification of the optimal strategy requires an adequately powered, multicentre, randomised clinical trial.
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Maurizio Paciaroni (2005) studied this question.
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