Affiliation:
1. Federal State Budgetary "Institution Research Institute for Complex Issues of Cardiovascular Diseases".
Abstract
Aim To evaluate in-hospital and long-term outcomes of myocardial and cerebral revascularization with combined or staged PCI and carotid endarterectomy.Methods.263 myocardial and cerebral revascularizations with PCI and CEA in patients with combined cerebral and coronary artery lesions in the period from 2011 to 2017 were performed. Patients were divided into two groups depending on the surgical strategy. Patient (n = 133) who underwent a staged intervention (CEA and PCI) were included in Group 1, whereas patients (n = 130) who underwent a hybrid intervention (CEE+PCI CA) were included in Group 2. The mean follow-up was 3.5 years.Results.100% of patients in Group 2 underwent coronary and internal carotid revascularization according to the results of in-hospital and long-term follow-up. 81.35% of patient in Group 1 underwent PCI and CEA, whereas 3.01% of patients underwent only PCI and 6.77% of patients – CEA. 1.5% of patients in Group 1 did not receive any surgical treatment. The most common causes of incomplete revascularization were the subsequent change of the initially defined treatment for myocardial (6.02%) or cerebral revascularization (0.75%). The rest refused the second stage, or it was associated with extremely high risk and the strategy was switched to the conservative therapy.Conclusion.100% of patients received hybrid myocardial and cerebral revascularization during one hospitalization. It allowed reducing mortality from MI and stroke during the waiting period for the next stage of the treatment in Group 1 (almost 5%). Hybrid interventions can be used in patients with high risk for open-heart surgery, severe comorbidities (obesity, diabetes, renal dysfunction), significant coronary and cerebral artery lesions with high risk of MI and stroke. However, hybrid approach was associated with high rate (almost 7%) of non-fatal MI in the long-term follow-up.
Subject
Cardiology and Cardiovascular Medicine,Critical Care and Intensive Care Medicine,Rehabilitation,Emergency Medicine,Surgery
Reference32 articles.
1. Chernyavskij A. M., Chernyavskij M. A., Vinogradova T. E., Edemskij A. G. Gibridnye tekhnologii pri hirurgicheskom lechenii sochetannogo ateroskleroticheskogo porazheniya koronarnyh i sonnyh arterij. Patologiya krovoobrashcheniya i kardiohirurgiya. 2013;17(1):45-53. (In Russian) http://dx.doi. org/10.21688/1681-3472-2013-1-45-53
2. Shevchenko Yu.L., Popov L.V., Batrashev V.A., Bajkov V.Yu. Rezul'taty hirurgicheskogo lecheniya pacientov s sochetannym ateroskleroticheskim porazheniem koronarnyh i brahiocefal'nyh arterij. Bulletin of Pirogov National Medical & Surgical Center. 2014; 9 (1): 14-17. (In Russian)
3. Bajkov V.Yu. Combined atherosclerotic coronary and brachiocephalic arteries – choice of surgical tactics. Bulletin of Pirogov National Medical & Surgical Center. 2013; 8 (4): 108111. (In Russian)
4. M.V. Ezhov, I.V. Sergienko, D.M. Aronov. Diagnostics and correction of lipid metabolism disorders in order to prevent and treat atherosclerosisю Russian recommendations VI revision. 2017; 3: 5-22. (In Russian)
5. R.S. Tarasov, A.N. Kazantsev, S.V. Ivanov, E.S. Kagan, K.E. Glinchikov, L.S. Barbarash. Personalized choice of the optimal revascularization strategy in patients with combined lesions of coronary and brachiocephalic arteries: results of testing an automated decision support system in clinical practice. Russian Cardiology Bulletin. 2018; 13 (1): 30-39. (In Russian) https://doi:10.17116/Cardiobulletin201813130-39
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