Key result
A strategy of preoperative coronary evaluation, indicated revascularization, and intraoperative adjunctive therapy resulted in zero perioperative coronary ischemic complications among 224 patients undergoing carotid artery stenting.
Why the study?
To report outcomes of a strategy using preoperative coronary assessment, coronary revascularization, or intraoperative adjunctive therapy to prevent perioperative ischemic heart disease during CAS.
Does a strategy of preoperative coronary assessment and targeted revascularization or intraoperative adjunctive therapy prevent perioperative ischemic heart disease in patients undergoing carotid artery stenting?
Observational (n=224)
No
Does a strategy of preoperative coronary assessment and targeted revascularization or intraoperative adjunctive therapy prevent perioperative ischemic heart disease in patients undergoing carotid artery stenting?
A strategy of preoperative coronary evaluation and targeted revascularization or intraoperative adjunctive therapy during carotid artery stenting may effectively prevent perioperative coronary ischemic complications.
Preoperative coronary evaluation plus selective intervention yielded zero periprocedural ischemic events in this CAS cohort; leaves open whether the strategy reduces risk versus standard care.
Objectives: We have been performing preoperative coronary artery assessments and implementing coronary revascularization or intraoperative adjunctive therapies as needed in patients scheduled for carotid artery stenting (CAS) to prevent ischemic heart disease. In this study, we report the results of a retrospective observation of patients who underwent CAS under our treatment strategy to prevent perioperative coronary ischemic complications. Methods: A total of 224 cases from January 2014 to December 2021 were included. Following preoperative coronary artery CTA, preoperative coronary artery treatment or intraoperative adjunctive therapy (temporary transcutaneous cardiac pacemaker [TTCP] or intra-aortic balloon pumping [IABP]) was performed based on the degree of stenosis. We analyzed the outcomes of patients treated with CAS under this strategy at our institution. Results: Coronary artery disease was detected preoperatively in 143 cases (64%), with 91 cases (41%) indicated for coronary revascularization. Preoperative coronary artery treatment was performed in 76 cases (34%) prior to CAS, and adjunctive therapy with TTCP or IABP was provided in 28 cases (13%) during the procedure. No case developed perioperative coronary ischemic complication. Conclusion: In patients who have undergone CAS, perioperative coronary ischemic complications might be reduced by evaluating the risk of ischemic heart disease preoperatively, performing pre-CAS coronary artery intervention based on the severity of the lesions, and administering intraoperative adjunctive therapy.
No takes yet. Share an insight, caveat, or question.
Fukuta et al. (2024) conducted an observational in Carotid artery stenosis (n=224). Preoperative coronary evaluation, indicated revascularization, and intraoperative adjunctive therapy (TTCP/IABP) was evaluated on Perioperative coronary ischemic complication. A strategy of preoperative coronary evaluation, indicated revascularization, and intraoperative adjunctive therapy resulted in zero perioperative coronary ischemic complications among 224 patients undergoing carotid artery stenting.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: