Key result
Myocardial revascularization was performed prior to carotid revascularization in a patient with unstable angina and asymptomatic severe right internal carotid artery stenosis.
Why the study?
Coexisting carotid artery stenosis and coronary artery disease is common, but treatment guidelines lack consensus on the timing, sequence, and methods of revascularization.
Case Report (n=1)
This case highlights that in coexisting severe coronary and carotid disease, the sequence of revascularization can be guided by symptom severity, prioritizing unstable coronary symptoms.
May warrant coronary-first sequencing in unstable angina with asymptomatic carotid stenosis; single case leaves optimal strategy open.
Coexisting carotid artery stenosis and coronary artery disease is common and there is currently no consensus in treatment guidelines on the timing, sequence and methods of revascularization. We report a case of a patient with symptomatic triple vessel coronary artery disease as well as asymptomatic severe right internal carotid artery stenosis. Our patient underwent myocardial revascularization first, because she presented with unstable angina and was asymptomatic neurologically. This article summarizes current literature about the approach to carotid and coronary artery revascularization and addresses the decision-making process regarding the timing and sequence of revascularization.
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Manthey et al. (2020) conducted a case report in Coexisting carotid artery stenosis and coronary artery disease (n=1). Myocardial revascularization first was evaluated. Myocardial revascularization was performed prior to carotid revascularization in a patient with unstable angina and asymptomatic severe right internal carotid artery stenosis.
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