Asymptomatic severe carotid stenosis undergoing staged carotid artery stent and coronary artery bypass grafting: decisive role of brain single photon emission computed tomography

Gen Thorac Cardiovasc Surg. 2009 Jan;57(1):40-2. doi: 10.1007/s11748-008-0323-y. Epub 2009 Jan 22.

Abstract

Effort angina of a 70-year-old man was diagnosed as due to triple coronary vessel disease, and he was scheduled to undergo coronary artery bypass surgery. Preoperative carotid duplex scan revealed more than 75% stenosis of the right internal carotid artery, which was functionally proven to be significantly ischemic on brain single photon emission computed tomography. Although he was neurologically asymptomatic, we chose staged surgery for fear of stroke during coronary artery bypass surgery. He had successful carotid artery stenting first by neurosurgeons; then, 2 months later he underwent uneventful coronary artery bypass surgery. This experience prompted us to report the case.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty / instrumentation*
  • Brain* / blood supply
  • Brain* / diagnostic imaging
  • Carotid Artery, Internal / pathology
  • Carotid Artery, Internal / surgery
  • Carotid Stenosis / complications
  • Carotid Stenosis / pathology
  • Carotid Stenosis / physiopathology
  • Carotid Stenosis / surgery*
  • Cerebrovascular Circulation*
  • Coronary Artery Bypass*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / surgery*
  • Humans
  • Magnetic Resonance Angiography
  • Male
  • Severity of Illness Index
  • Stents*
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed
  • Treatment Outcome