Safety and Feasibility of Simultaneous Transcarotid Revascularization With Flow Reversal and Coronary Artery Bypass Grafting for Concomitant Carotid Artery Stenosis and Coronary Artery Disease.

Journal Article (Journal Article)

OBJECTIVE: The management of patients with combined severe carotid artery and coronary artery disease (CAD) is controversial. Transcarotid stenting with flow reversal (TCAR) is a novel hybrid technique for carotid revascularization. We sought to investigate the safety and feasibility of simultaneous TCAR and coronary artery bypass grafting (CABG) for concomitant carotid and CAD. METHODS: A single-institution, retrospective study of patients with critical carotid artery stenosis and symptomatic CAD who underwent simultaneous TCAR-CABG was completed. The primary outcomes were technical success, perioperative stroke, death, and hemorrhage. RESULTS: Four patients underwent TCAR-CABG. All patients were male with a mean age of 64. Technical success was achieved in all cases. There were no perioperative strokes or deaths. There were no reexplorations for hemorrhage. CONCLUSIONS: Transcarotid stenting with flow reversal-CABG is a technically feasible hybrid approach for simultaneous carotid and coronary revascularization. It should be part of the vascular surgeon's armamentarium for coexisting carotid and coronary disease. Further research focused on patient selection and perioperative antiplatelet management is warranted prior to the widespread adoption of this technique.

Full Text

Duke Authors

Cited Authors

  • Williams, Z; Olivere, LA; Gilmore, B; Weissler, H; Cox, MW; Long, C; Shortell, CK; Schroder, J; Southerland, KW

Published Date

  • July 2020

Published In

Volume / Issue

  • 54 / 5

Start / End Page

  • 395 - 399

PubMed ID

  • 32319354

Pubmed Central ID

  • PMC7324014

Electronic International Standard Serial Number (EISSN)

  • 1938-9116

Digital Object Identifier (DOI)

  • 10.1177/1538574420918971


  • eng

Conference Location

  • United States