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Combining Endarterectomy, Bypass May Boost Mortality

Study finds 38 percent higher chance of death with both surgeries compared to bypass alone

TUESDAY, Jan. 16 (HealthDay News) -- Performing a carotid endarterectomy at the same time as coronary artery bypass grafting may increase the chance of death or stroke compared to bypass alone, according to a report in the Jan. 16 issue of Neurology.

Richard Dubinsky, M.D., and Sue Min Lai, Ph.D., from the University of Kansas Medical Center in Kansas City, used the U.S. Nationwide Inpatient Sample -- a database of inpatient and discharge information from nearly 1,000 hospitals -- to determine hospital mortality and postoperative stroke rates after combined carotid endarterectomy (CEA) and coronary artery bypass graft surgery (CABG) compared with CABG alone.

The study found a 38 percent greater chance of death or postoperative stroke among patients receiving both of the treatments compared to those receiving coronary artery bypass graft surgery alone.

"The frequency of combined CEA/CABG has increased, but the reported case series are inadequate to conclude whether there is a benefit to combining the procedures," the authors write. Further randomized controlled trials are needed to address this more accurately.

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