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B.G. Alekyan
A.V. Vishnevsky National Medical Research Center of Surgery, Russian FederationTitle: A multidisciplinary approach in assessing the prevalence of coronary artery disease and selecting treatment strategies in patients with aortic and peripheral artery diseases
Abstract
Aim: To assess the prevalence of CAD and select
optimal treatment strategies in patients with aortic and peripheral artery
diseases using the multidisciplinary approach.
Material and methods: 693 patients present with aortic
and peripheral artery diseases were recruited. Of them, 171 (32.5%) were
female, and 522 (75.3%) were male. The mean age of patients was 67.2+8.8 years.
32.5% of patients (n=223) were older than 71 years. 203 (29.3%) patients were
symptomatic, whereas 490 (70.7%) were asymptomatic. 196 (28.3%) patients had an
isolated lesion of the internal carotid artery (ICA). 93 (13.4%) patients had a
combined lesion of the ICA and lower limb arteries, 70 (10.1%) and 60 (8.6%)
patients had a combined lesion of the iliac and superficial femoral arteries, and
femoral arteries lesions, respectively.
Results. 554 (79.9%) of 693 patients had lesions of at
least one lumen diameter stenosis of ?50%. Of them, 368 (66.4%) patients were
clinically asymptomatic. By the decision of the multidisciplinary heart team,
316 (57.0%) patients underwent myocardial revascularization: 21 (6.7%) —
coronary artery bypass grafting, and 295 (50.3%) — percutaneous coronary
intervention. Surgical and endovascular interventions for aortic and peripheral
artery diseases were performed in 486 (70.1%) patients. 226 (46.5%) patients
required vascular surgery in addition to myocardial revascularization. A total
of 923 surgeries (564 endovascular and 359 open-heart surgeries) were performed
in 580 patients in the in-hospital period. Three (0.51%) patients died. Two
(0.56%) patients had stroke following ICA grafting and ICA thrombosis after carotid
endarterectomy. In-hospital acute myocardial infarction was not detected in any
of the patients.
Conclusion. 79.9% of patients with aortic and
peripheral artery diseases had at least at least one lumen diameter stenosis of
?50%. 66.4% of patients with aortic and peripheral artery disease and coronary
artery stenotic lesions over 50% did not have any complaints. 45.6% of patients
admitted to the hospital with atherosclerotic lesions of the aorta and
peripheral arteries required myocardial revascularization. A multidisciplinary
approach is an effective and safe management strategy for patients with aortic
and peripheral artery disease and concomitant CAD.
Biography
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