Introduction
Coronary bypass surgery is a surgical method for the coronary heart disease’s treatment. Despite its widespread use, the operation can have several complications, the most devastating of which is a postoperative stroke. The developing ACVA(acute cerebrovascular accident) 30-day risk after CABG (coronary artery bypass grafting) is 1.1% [1]. In the carotid artery damage’s presence, the ACVA risk increases to 2.75%, and the 30-day mortality risk is 2.59% [2]. Coronary heart disease is the main death cause in patients with the carotid arteries’ atherosclerotic lesions [3].
Patients who have undergone CEA(carotid endarterectomy) have a higher risk of developing MI(myocardial infarction) than ACVA, and patients with postoperative MI have a 5-year survival rate of only 56% [4].
To date, there aren’t high-class evidence recommendations for the patients’ treatment with the coronary and brachiocephalic arteries’ combined atherosclerotic lesions. The ESC/ESVS Recommendations for the peripheral artery diseases’ diagnosis and treatment in 2017 regarding the coronary and carotid arteries’ combined atherosclerosis contain the provision: for the carotid artery revascularization in patients requiring CABG, an individual indications discussion (and if any, the method and time) is recommended for each patient by a multidisciplinary specialists’ team , including a neurologist (class I, level C) [5]. ESC/EACTS recommendations on myocardial revascularization in 2018 on this issue repeat the recommendations for the patients with peripheral artery disease’s management in 2017 [6]. We want to present our treating this cohort of patients’ experience, to show immediate and long-term results.