ASSOCIATED CAROTID AND CORONARY LESIONS - ROLE OF ENDOLUMINAL CAROTIDANGIOPLASTY BEFORE BYPASS-SURGERY

Objectives: There is debate over the therapeutic strategy in patients, vith lesions of both the coronary arteries and the carotid arteries. I mprovement in angioplasty techniques for the carotid artery would be a minimally invasive alternative. Methods: Between January 1993 and Jun e 1995, 12 patients who underwent endoluminal angioplasty of the carot id artery before coronary bypass surgery (mean 17.9 days before) were included in the study. Mean age was 70+/-3.2 years, The carotid lesion s were asymptomatic in all patients who had stable angina, Results: Th e mean number of bypasses was 2.9 per patient, Five patients had a con tralateral stenosis of the internal carotid artery, Angioplasty was pe rformed under cerebral protection using a three way coaxial catheter. A Strecker stent was required in 8 cases, One patient presented transi ent hemianopsia. All patients were seen again at 4 months for an angio gram then at 6 months for a Doppler examination, One patient needed co mplete redilatation with a stent and one other required dilatation of the stent, Conclusion: Endoluminal angioplasty of the carotid arteries gave encouraging results in this high-risk population (underlying dis ease, age, bilateral carotid lesions, arterial coronary grafts). This technique should be used more widely for patients with severe multiple arterial lesions.