Abstract

In carotid artery disease patients with concomitant significant coronary artery disease (CAD - especially left main diseases – LMCA), the risk of perioperative myocardial infarction and early and late death are increased. Conversely, in patients undergoing coronary artery bypass surgery (CABG), uncorrected severe carotid disease increases the risk of adverse neurologic events [1]. The optimal management of these co-existing conditions and the timing and sequence of correcting them remain controversial. Over the past 2 decades, staged carotid revascularisation followed by CABG, staged CABG followed by carotid revascularisation, or combined coronary and carotid revascularisation simultaneously in one operative setting have each been advocated. Our patient presented with both carotid and significant LMCA CAD, first we have done carotid intervention followed one week later by LMCA percutaneous coronary intervention (PCI).