Historical aspects and the current state of treatment of combined coronary and carotid artery disease

Abstract

In this study the primary focus will be on the problem of choosing the treatment tactic in patients with multifocal atherosclerosis. Nowadays, optimal timing of surgical interventions in these patients is controversial. In clinical practice it is usually determined by the severity of the combined coronary and carotid artery disease and the symptoms in patients. There are two main strategies: a staged approach, in which the most affected arteries are primarily revascularized, and a synchronous approach, in which carotid endarterectomy (CEA) and coronary revascularization are performed simultaneously. The presence of severe carotid artery disease is an important incremental risk factor for myocardial infraction after coronary artery bypass grafting (CABG) and needs either concomitant or staged surgical correction. In the absence of randomized controlled trials, guidelines regarding the management of these patients are based on data from single-center retrospective studies. The article indicates historical aspects and current research on multifocal atherosclerosis, as well as clinical guidelines for the management of these patients