ASYMPTOMATIC CAROTID STENOSIS IN PATIENTS UNDERGOING MAJOR CARDIAC-SURGERY - CAN PERCUTANEOUS CAROTID ANGIOPLASTY BE AN ALTERNATIVE

Objective: As the mortality associated with coronary artery bypass gra fts has fallen, morbidity has become an increasing problem. The improv ement of transluminal carotid angioplasty is enlarged to patients with asymptomatic severe carotid stenosis (>85%) requiring coronary surger y. Methods: Between January 1993 and January 1995, 10 patients underwe nt percutaneous carotid angioplasty prior to cardiac surgery (17.4 day s). Mean age was 71+/-4.3 years. Four patients showed a contralateral occlusion of the internal carotid artery. Transluminal carotid angiopl asty was carried out with a triple coaxial catheter system. Six angiop lasties required a Strecker stent. Results: Mean follow-up was 11.4 mo nths. No mortality was observed. Only one patient showed a transient h emianopsia. All patients underwent angiography at four months. Two pat ients required a new procedure of carotid angioplasty completed with a Strecker stent in one case and by dilatation of a stent in another pa tient. Conclusion: The results of transluminal carotid angioplasty, in this short series, are encouraging in this group of high-risk morbidi ty and mortality (elderly patients, bilateral carotid lesions, multipl e coronary arterial grafts). (C) 1997 Elsevier Science B.V.