MODERN SURGICAL APPROACHES TO THE TREATMENT OF COMBINED ATHEROSCLEROTIC DAMAGE OF THE CORONARY AND CAROTID ARTERIES
Annotatsiya
The number of patients with brachiocephalic artery disease and coronary artery disease (CHD) is steadily increasing. Despite the achieved results in the surgical treatment of patients with lesions of the brachiocephalic arteries and concomitant coronary artery disease, the world has not yet reached a consensus on the tactics of treating this group of patients. Most patients with concomitant coronary and carotid artery disease have a combination of two or more risk factors for neurological complications. In addition, for elderly patients, the time of artificial circulation and the duration of the operation are of decisive importance. An increase in this time is inevitable with a single-stage surgical operation. Carotid endarterectomy or carotid stenting is indicated before or simultaneously with coronary artery bypass grafting in symptomatic patients with 80% carotid stenosis (LE: C). However, until data from randomized clinical trials are available, the surgical approach to patients with severe coronary and carotid lesions will be individualized, based on the specific risk level of each patient and the experience of the institution.