Conventional coronary artery bypass grafting in patients with total occlusion of the internal carotid artery

The number of patients with coexisting disease of the coronary and carotid arteries is increasing. Patients with total occlusion of the carotid artery may have a higher risk of stroke during cardiopulmonary bypass surgery and in the perioperative period. We report our results for coronary artery byp ass grafting (CABG) in patients with total occlusion of the carotid artery. We examined 269 patients who underwent carotid artery duplex scanning (CAD S) before CABG between November 1995 and January 1998. Among them. 11 patie nts (4.1%) had total occlusion of a carotid artery. Four patients underwent elective CABG and five underwent emergency CABG. One patient underwent ana stomosis of the superficial temporal artery to the middle cerebral artery ( STMC) and one patient underwent a combined CABG and carotid endoarterectomy (CEA) procedure. A transient neurological event occurred in only one patie nt (9.1%). The other patients recovered uneventfully. Our results suggest t hat CABG can be performed without stroke in patients with total unilateral occlusion of a carotid artery using our strategies.