One-Stage Carotid and Coronary Artery Surgeries in the Treatment of Multifocal Atherosclerosis

One of the most severe forms of multifocal atherosclerosis often accompanied by heart attacks and strokes is concomitant coronary and carotid artery disease. Unfortunately to date there have been no qualitative randomized trials allowing us to develop a unified optimal approach to the treatment of this pathology. We have analyzed the treatment of 128 patients with coronary artery disease and atherosclerotic carotid stenosis operated on the two vascular territories over the past 10 years in the Department of Surgery of the Aorta and its Branches of the Petrovsky National Research Center of Surgery. One-stage reconstruction in two arterial basins was performed on the majority (75%) of patients. Other patients underwent multistage procedures including the use of endovascular techniques. The absence of any significant differences in mortality and postoperative complications between groups subjected to single- and multi-stage treatment, doubtless reduction of risk of vascular complications in uncorrected arterial bed by one-stage reconstruction allows us to consider this treatment strategy the method of choice in the management of this pathology. Overall surgical mortality of patients with combined coronary and carotid artery involvement subjected to our strategy was 0.8%.