J Med Assoc Thai 2002; 85 (11):1232

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Bilateral Carotid Stenting Prior to Coronary Artery Bypass Graft A Case Report
Srimahachota S Mail, Singhatanadgige S , Boonyaratavej S , Chayanont D

SERI SINGHATANADGIGE, M.D.**,
DUANCHAI CHAYANONT,M.D.*
Background : Carotid stenosis is an independent possible complication of the central
nervous system of patients after receiving a coronary artery bypass graft (CABG). The risk increases
when the patient has bilateral carotid stenosis even if asymptomatic.
Case report : A 76 year-old female was admitted because of unstable angina. The coronary
angiography showed triple vessel disease and required CABG for revascularization. Her physical
examination revealed bilateral carotid bruits. She did not have any history of neurological deficit.
Carotid Doppler showed critical stenosis of bilateral carotid arteries. The carotid angiography demon-
strated 70 per cent diameter stenosis of both internal carotid arteries just above the bifurcation of the
external carotid artery. A 7 x 20 mm self-expandable Smart@ stent was implanted first in the right
carotid artery with good angiographic result. Five days later, another 7 x 20 mm self-expandable SmartเธŽ
stent was implanted in the left carotid artery without residual stenosis. The patient did not have any
cardiovascular complications. CABG was performed 2 weeks later with a good result. The patient was
discharged 10 days after CABG.
Conclusion : Bilateral carotid stenting is feasible and produces an acceptable outcome. This
procedure is an alternative treatment for preventing stroke during CABG surgery.
Key word : Coronary Artery Disease, Coronary Artery Bypass Graft, Carotid Stenosis, Carotid
Stent

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