{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T11:24:02Z","timestamp":1769945042229,"version":"3.49.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2000,8,1]],"date-time":"2000-08-01T00:00:00Z","timestamp":965088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Surgery"],"published-print":{"date-parts":[[2000,8]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> Results of synchronous combined revascularization were examined in specific patient groups with coexistent coronary and cerebrovascular diseases. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Between 1.1.1980 and 31.12.1998, 408 patients underwent a synchronous combined carotid endarterectomy (CEA) + myocardial revascularization (CABG). In 259 (63.5%) patients, carotid disease was asymptomatic. Remaining patients presented with a previous stroke ( n = 35) or a transient ischemic episode (TIA) ( n = 114). In 245 (60%) patients, carotid stenosis was bilateral (Group A: bilateral \u2265 80% stenosis. Group B: contralateral occlusion, Group C: contralateral subcritical disease). A synchronous ipsilateral CEA + CABG was performed in all patients with an unilateral disease ( n = 163) and also in all Group B ( n = 33) and Group C ( n = 142) patients with bilateral disease. A simultaneous bilateral CEA + CABG was performed in 12 high risk Group A patients. Remaining Group A patients ( n = 58), initially underwent an ipsilateral CEA for most dominant lesion + CABG, soon followed by the contralateral CEA. Results were examined in above specific patient Groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> Overall combined hospital mortality from stroke + myocardial infarction was 2.45%. No independent predictor of stroke was identified. In general, initial prophylactic CEA, subdued the risk of subsequent strokes for 7\u20138 yr. Predictors of a late stroke were: progression of bilateral ( P = 0.007) and intracranial ( P = 0.04) cerebrovascular disease. Highest risk of an early stroke was recorded in Group A patients. A composite high risk group of patients with multiple risk factors ( n = 155) demonstrated a higher risk of both early and late strokes, as compared to the remaining patients ( n = 253) ( P &lt; 0.04). Observed risk of early and late strokes, in specific patient groups was lower than standard predictions. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p> A regular use of combined approach was justified in the above patient groups. <\/jats:p><\/jats:sec>","DOI":"10.1177\/096721090000800507","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T17:50:03Z","timestamp":1727113803000},"page":"355-365","source":"Crossref","is-referenced-by-count":3,"title":["Coexistent Coronary and Cerebrovascular Disease: Results of Simultaneous Surgical Management in Specific Patient Groups"],"prefix":"10.1177","volume":"8","author":[{"given":"T. K.","family":"Kaul","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. L.","family":"Fields","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. S.","family":"Riggins","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. A.","family":"Wyatt","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. R.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Baptist Medical Center, 817 Princeton Avenue SW, Birmingham, AL 35211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2000,8,1]]},"reference":[{"key":"bibr1-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)37543-9"},{"key":"bibr2-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1972.04180120018005"},{"key":"bibr3-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(89)70010-0"},{"key":"bibr4-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.2.566"},{"key":"bibr5-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)90303-8"},{"key":"bibr6-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(91)90315-H"},{"key":"bibr7-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)90255-3"},{"key":"bibr8-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1159\/000174989"},{"key":"bibr9-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1378\/chest.106.5.1349"},{"key":"bibr10-096721090000800507","first-page":"723","volume":"30","author":"Minami K.","year":"1989","journal-title":"Journal of Cardiovascular Surgery"},{"key":"bibr11-096721090000800507","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1161\/01.CIR.66.3.496","volume":"66","author":"Schwartz R.L.","year":"1982","journal-title":"Circulation"},{"key":"bibr12-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/0003-4975(92)91442-C"},{"key":"bibr13-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1986.10478314"},{"key":"bibr14-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(92)90930-W"},{"key":"bibr15-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198402000-00016"},{"key":"bibr16-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)63702-2"},{"key":"bibr17-096721090000800507","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)64759-5"},{"key":"bibr18-096721090000800507","unstructured":"Quinones-Baldrich W. 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