SURVIVAL RATE IN PATIENTS WITH MULTIFOCAL ATHEROSCLEROSIS WHO UNDERWENT SURGICAL CAROTID AND CORONARY REVASCULARISATION.

Aim - short-term outcomes of cerebral and coronary artery revascularisation surgeries performed with different methods and different timing have been well studied, but the long-term outcomes have not. The study aim was to determine the long-term survival rates in patients with combined atherosclerotic cerebral and coronary artery lesions who underwent surgical revascularisation of both territories. We evaluated the survival functions of six groups of patients with combined atherosclerotic cerebral and coronary artery lesions who underwent revascularisation using different methods in different sequences and at different time periods of both territories. Survival in each group was determined from postoperative Day 30 by using the Kaplan-Meier method and compared by using the log-rank test. Survival was also compared among the groups in which alternative methods of carotid and coronary territories revascularisation were used. The 5-year survival rates were similar between patients who underwent endovascular revascularisation of both territories (cerebral and coronary arteries stenting) or combined surgery (coronary arteries stenting + carotid endarterectomy). The 5-10-year survival rate was higher in patients who underwent combined surgery than in the other patients (p=0.026). The main causes of death in all groups were cardiac or cerebral events. The 10-year survival rates did not significantly differ between patients who underwent cerebral artery stenting prior to coronary artery bypass grafting and those who underwent simultaneous carotid endarterectomy + coronary artery bypass grafting (p=0.532). The results of this study can be useful for selecting the tactics of surgical cerebral and coronary artery revascularisation, identifying the sequence of respective surgeries and time management.