Carotid Artery Stent Placement Prior to Coronary Angioplasty or Coronary Bypass Graft Surgery.

Patients with concomitant carotid and coronary artery disease are at high risk of both cardiac and cerebrovascular complications when they undergo revascularization procedures. The best management strategies for patients with concomitant disease have not been determined for certain. Staged surgical procedures with either coronary artery bypass grafting prior to carotid endarterectomy or vice versa appear to be associated with an increased risk of ischemic complications compared to separate procedures. Until recently, there were no convincing data favoring a simultaneous or combined revascularization approach. Carotid artery stenting has emerged as a treatment option in patients with cerebrovascular disease, even in the presence of a high cardiac risk. Recent results in patients with severe concomitant coronary artery disease are encouraging. This report focuses on the treatment of severe carotid artery stenosis by stent implantation in patients with life-threatening comorbidity to emphasize the possibility of this endovascular approach as an alternative treatment option.