Staged coronary artery bypass grafting after percutaneous angioplasty for intracranial vascular stenosis
Objective: Cerebrovascular disease is commonly associated with coronary artery disease and is a major risk factor for cardiac surgery. Concomitant coronary artery bypass grafting and carotid endarterectomy may reduce the risk of stroke; however, this staged operation is effective only for extracrani...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2001-09, Vol.122 (3), p.608-610 |
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| creator | Kihara, Shin'ichiro Shimakura, Tadayuki Tanaka, Satoshi A. Hanayama, Naoji Saito, Norihiko Hirasawa, Yujiro Sugawara, Yuji Maeba, Satoru Yoshizumi, Hideyuki |
| description | Objective: Cerebrovascular disease is commonly associated with coronary artery disease and is a major risk factor for cardiac surgery. Concomitant coronary artery bypass grafting and carotid endarterectomy may reduce the risk of stroke; however, this staged operation is effective only for extracranial lesions. The strategy for on-pump coronary artery bypass grafting for patients with intracranial vascular stenosis is still controversial.
Methods: The subjects were 157 consecutive candidates for coronary artery bypass grafting who underwent computed tomography and digital subtraction cerebral angiography preoperatively to check for cerebrovascular disease. Additional single-photon emission computed tomography was performed to evaluate cerebral ischemia, according to the neurologist's request. Patients with diffuse intracranial vascular stenosis impossible to treat with percutaneous transluminal angioplasty underwent off-pump coronary artery bypass grafting. Patients with a circumflex coronary artery lesion first underwent percutaneous transluminal angioplasty for cerebral vascular stenosis followed by secondary on-pump coronary artery bypass grafting.
Results: Three patients were selected for staged operations. Percutaneous transluminal angioplasty was performed for 4 intracranial stenotic lesions. All lesions were dilated successfully, and no complications developed during or after the procedure. All patients tolerated staged coronary artery bypass grafting and were extubated within 1 day without any mental disturbance. No further neurologic complication occurred, and computed tomography performed postoperatively revealed no significant changes.
Conclusion: Staged on-pump coronary bypass after percutaneous transluminal angioplasty for cerebrovascular disease may reduce the risk of stroke during cardiopulmonary bypass, and it is useful especially in patients with intracranial cerebrovascular disease. |
| doi_str_mv | 10.1067/mtc.2001.115159 |
| format | Article |
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Methods: The subjects were 157 consecutive candidates for coronary artery bypass grafting who underwent computed tomography and digital subtraction cerebral angiography preoperatively to check for cerebrovascular disease. Additional single-photon emission computed tomography was performed to evaluate cerebral ischemia, according to the neurologist's request. Patients with diffuse intracranial vascular stenosis impossible to treat with percutaneous transluminal angioplasty underwent off-pump coronary artery bypass grafting. Patients with a circumflex coronary artery lesion first underwent percutaneous transluminal angioplasty for cerebral vascular stenosis followed by secondary on-pump coronary artery bypass grafting.
Results: Three patients were selected for staged operations. Percutaneous transluminal angioplasty was performed for 4 intracranial stenotic lesions. All lesions were dilated successfully, and no complications developed during or after the procedure. All patients tolerated staged coronary artery bypass grafting and were extubated within 1 day without any mental disturbance. No further neurologic complication occurred, and computed tomography performed postoperatively revealed no significant changes.
Conclusion: Staged on-pump coronary bypass after percutaneous transluminal angioplasty for cerebrovascular disease may reduce the risk of stroke during cardiopulmonary bypass, and it is useful especially in patients with intracranial cerebrovascular disease.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1067/mtc.2001.115159</identifier><identifier>PMID: 11547317</identifier><identifier>CODEN: JTCSAQ</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Aged ; Angiography, Digital Subtraction ; Angioplasty, Balloon - methods ; Biological and medical sciences ; Brain Ischemia - classification ; Brain Ischemia - complications ; Brain Ischemia - diagnosis ; Brain Ischemia - therapy ; Cerebral Angiography ; Cerebral Arteries ; Constriction, Pathologic ; Coronary Artery Bypass - methods ; Coronary Disease - complications ; Coronary Disease - surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Patient Selection ; Risk Factors ; Severity of Illness Index ; Stents ; Stroke - etiology ; Stroke - prevention & control ; Stroke Volume ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Time Factors ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2001-09, Vol.122 (3), p.608-610</ispartof><rights>2001 The American Association for Thoracic Surgery</rights><rights>2002 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c446t-87a921c2688ca6e381625187f4cfb54f9be630424d1a3fc8deb0f157b0ec51da3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1067/mtc.2001.115159$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14065557$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11547317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kihara, Shin'ichiro</creatorcontrib><creatorcontrib>Shimakura, Tadayuki</creatorcontrib><creatorcontrib>Tanaka, Satoshi A.</creatorcontrib><creatorcontrib>Hanayama, Naoji</creatorcontrib><creatorcontrib>Saito, Norihiko</creatorcontrib><creatorcontrib>Hirasawa, Yujiro</creatorcontrib><creatorcontrib>Sugawara, Yuji</creatorcontrib><creatorcontrib>Maeba, Satoru</creatorcontrib><creatorcontrib>Yoshizumi, Hideyuki</creatorcontrib><title>Staged coronary artery bypass grafting after percutaneous angioplasty for intracranial vascular stenosis</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Objective: Cerebrovascular disease is commonly associated with coronary artery disease and is a major risk factor for cardiac surgery. Concomitant coronary artery bypass grafting and carotid endarterectomy may reduce the risk of stroke; however, this staged operation is effective only for extracranial lesions. The strategy for on-pump coronary artery bypass grafting for patients with intracranial vascular stenosis is still controversial.
Methods: The subjects were 157 consecutive candidates for coronary artery bypass grafting who underwent computed tomography and digital subtraction cerebral angiography preoperatively to check for cerebrovascular disease. Additional single-photon emission computed tomography was performed to evaluate cerebral ischemia, according to the neurologist's request. Patients with diffuse intracranial vascular stenosis impossible to treat with percutaneous transluminal angioplasty underwent off-pump coronary artery bypass grafting. Patients with a circumflex coronary artery lesion first underwent percutaneous transluminal angioplasty for cerebral vascular stenosis followed by secondary on-pump coronary artery bypass grafting.
Results: Three patients were selected for staged operations. Percutaneous transluminal angioplasty was performed for 4 intracranial stenotic lesions. All lesions were dilated successfully, and no complications developed during or after the procedure. All patients tolerated staged coronary artery bypass grafting and were extubated within 1 day without any mental disturbance. No further neurologic complication occurred, and computed tomography performed postoperatively revealed no significant changes.
Conclusion: Staged on-pump coronary bypass after percutaneous transluminal angioplasty for cerebrovascular disease may reduce the risk of stroke during cardiopulmonary bypass, and it is useful especially in patients with intracranial cerebrovascular disease.</description><subject>Aged</subject><subject>Angiography, Digital Subtraction</subject><subject>Angioplasty, Balloon - methods</subject><subject>Biological and medical sciences</subject><subject>Brain Ischemia - classification</subject><subject>Brain Ischemia - complications</subject><subject>Brain Ischemia - diagnosis</subject><subject>Brain Ischemia - therapy</subject><subject>Cerebral Angiography</subject><subject>Cerebral Arteries</subject><subject>Constriction, Pathologic</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Selection</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Stents</subject><subject>Stroke - etiology</subject><subject>Stroke - prevention & control</subject><subject>Stroke Volume</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Time Factors</subject><subject>Tomography, Emission-Computed, Single-Photon</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kDuP1DAUhS0EYoeFmg65AaqZ9XViJynRanlIK1EAEp1141xnvMoL21k0_x6PMtJWVKf57tG5H2NvQRxA6OpmTPYghYADgALVPGM7EE2117X6_ZzthJByr6QsrtirGB-EEJWA5iW7ynRZFVDt2PFHwp46bucwTxhOHEOiHO1pwRh5H9AlP_U8BwW-ULBrwonmNXKcej8vA8Z04m4O3E8poA04eRz4I0a7Dhh4TDTN0cfX7IXDIdKbS16zX5_vft5-3d9___Lt9tP93palTvu6wkaClbquLWoqatBSQV250rpWla5pSReilGUHWDhbd9QKB6pqBVkFHRbX7MPWu4T5z0oxmdFHS8OwrTYVQNlorTJ4s4E2zDEGcmYJfswKDAhzlmuyXHOWaza5-eLdpXptR-qe-IvNDLy_APl7HFx2YX184kqhlVJn7uPGHX1__OsDmTjiMORaMA_JRpDSFEaLOpPNRlJW9ugpmGg9TZa6fGWT6Wb_37n_AMdipc0</recordid><startdate>20010901</startdate><enddate>20010901</enddate><creator>Kihara, Shin'ichiro</creator><creator>Shimakura, Tadayuki</creator><creator>Tanaka, Satoshi A.</creator><creator>Hanayama, Naoji</creator><creator>Saito, Norihiko</creator><creator>Hirasawa, Yujiro</creator><creator>Sugawara, Yuji</creator><creator>Maeba, Satoru</creator><creator>Yoshizumi, Hideyuki</creator><general>Mosby, Inc</general><general>AATS/WTSA</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010901</creationdate><title>Staged coronary artery bypass grafting after percutaneous angioplasty for intracranial vascular stenosis</title><author>Kihara, Shin'ichiro ; Shimakura, Tadayuki ; Tanaka, Satoshi A. ; Hanayama, Naoji ; Saito, Norihiko ; Hirasawa, Yujiro ; Sugawara, Yuji ; Maeba, Satoru ; Yoshizumi, Hideyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c446t-87a921c2688ca6e381625187f4cfb54f9be630424d1a3fc8deb0f157b0ec51da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Angiography, Digital Subtraction</topic><topic>Angioplasty, Balloon - methods</topic><topic>Biological and medical sciences</topic><topic>Brain Ischemia - classification</topic><topic>Brain Ischemia - complications</topic><topic>Brain Ischemia - diagnosis</topic><topic>Brain Ischemia - therapy</topic><topic>Cerebral Angiography</topic><topic>Cerebral Arteries</topic><topic>Constriction, Pathologic</topic><topic>Coronary Artery Bypass - methods</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Selection</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Stents</topic><topic>Stroke - etiology</topic><topic>Stroke - prevention & control</topic><topic>Stroke Volume</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Time Factors</topic><topic>Tomography, Emission-Computed, Single-Photon</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kihara, Shin'ichiro</creatorcontrib><creatorcontrib>Shimakura, Tadayuki</creatorcontrib><creatorcontrib>Tanaka, Satoshi A.</creatorcontrib><creatorcontrib>Hanayama, Naoji</creatorcontrib><creatorcontrib>Saito, Norihiko</creatorcontrib><creatorcontrib>Hirasawa, Yujiro</creatorcontrib><creatorcontrib>Sugawara, Yuji</creatorcontrib><creatorcontrib>Maeba, Satoru</creatorcontrib><creatorcontrib>Yoshizumi, Hideyuki</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kihara, Shin'ichiro</au><au>Shimakura, Tadayuki</au><au>Tanaka, Satoshi A.</au><au>Hanayama, Naoji</au><au>Saito, Norihiko</au><au>Hirasawa, Yujiro</au><au>Sugawara, Yuji</au><au>Maeba, Satoru</au><au>Yoshizumi, Hideyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Staged coronary artery bypass grafting after percutaneous angioplasty for intracranial vascular stenosis</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2001-09-01</date><risdate>2001</risdate><volume>122</volume><issue>3</issue><spage>608</spage><epage>610</epage><pages>608-610</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><coden>JTCSAQ</coden><abstract>Objective: Cerebrovascular disease is commonly associated with coronary artery disease and is a major risk factor for cardiac surgery. Concomitant coronary artery bypass grafting and carotid endarterectomy may reduce the risk of stroke; however, this staged operation is effective only for extracranial lesions. The strategy for on-pump coronary artery bypass grafting for patients with intracranial vascular stenosis is still controversial.
Methods: The subjects were 157 consecutive candidates for coronary artery bypass grafting who underwent computed tomography and digital subtraction cerebral angiography preoperatively to check for cerebrovascular disease. Additional single-photon emission computed tomography was performed to evaluate cerebral ischemia, according to the neurologist's request. Patients with diffuse intracranial vascular stenosis impossible to treat with percutaneous transluminal angioplasty underwent off-pump coronary artery bypass grafting. Patients with a circumflex coronary artery lesion first underwent percutaneous transluminal angioplasty for cerebral vascular stenosis followed by secondary on-pump coronary artery bypass grafting.
Results: Three patients were selected for staged operations. Percutaneous transluminal angioplasty was performed for 4 intracranial stenotic lesions. All lesions were dilated successfully, and no complications developed during or after the procedure. All patients tolerated staged coronary artery bypass grafting and were extubated within 1 day without any mental disturbance. No further neurologic complication occurred, and computed tomography performed postoperatively revealed no significant changes.
Conclusion: Staged on-pump coronary bypass after percutaneous transluminal angioplasty for cerebrovascular disease may reduce the risk of stroke during cardiopulmonary bypass, and it is useful especially in patients with intracranial cerebrovascular disease.</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>11547317</pmid><doi>10.1067/mtc.2001.115159</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angiography, Digital Subtraction Angioplasty, Balloon - methods Biological and medical sciences Brain Ischemia - classification Brain Ischemia - complications Brain Ischemia - diagnosis Brain Ischemia - therapy Cerebral Angiography Cerebral Arteries Constriction, Pathologic Coronary Artery Bypass - methods Coronary Disease - complications Coronary Disease - surgery Female Follow-Up Studies Humans Male Medical sciences Middle Aged Patient Selection Risk Factors Severity of Illness Index Stents Stroke - etiology Stroke - prevention & control Stroke Volume Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Time Factors Tomography, Emission-Computed, Single-Photon Tomography, X-Ray Computed Treatment Outcome |
| title | Staged coronary artery bypass grafting after percutaneous angioplasty for intracranial vascular stenosis |
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