الفهرس 
ANATOMY OF THE CAROTID ARTERIESOnly 14 pages are availabe for public view
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Abstract
Atherosclerosis is a systemic disease and continues to be major health problem throughout the world. Due to diffuse nature of atherosclerosis, there is an association between coronary and carotid arteries.
There are many risk factors that play a considerable role in the formation of atherosclerosis, the most important are: age, hypertension, hyperlipidimia, diabetes and smoking. Atherosclerosis is a process which is proven to increase with age.
Early Diagnosis of carotid artery stenosis in patients suffering from coronary insufficiency is important in proper management of the patient.
The overall incidence of stroke following coronary artery grafting continues to be a great source of morbidity and this incidence increases with the presence of significant carotid stenosis.
Duplex scanning is safe, relatively inexpensive measure for screening patients with carotid lesions and following disease progression. Patients that undergo CABG should undergo noninvasive studies of the carotid arteries by duplex scanning regardless their neurological symptoms and signs. There is a significant statistical correlation between the presence of severe coronary arteries lesion and severe carotid arteries lesion.
When associated vascular lesions are detected preoperatively, appropriate operative approach, perfusion technique, and postoperative treatment can be planned and thus reduce the risk of perioperative stroke.
When both arterial systems require surgical repair, three operative strategies have been proposed:
1. Both procedures can be conducted simultaneously.
2. a) The carotid surgery can be performed first followed by CABG.
b) The CABG can be performed first followed by CEA.
3. Carotid artery angioplasty with stenting (CAS) followed by cardiac surgery could offer a less invasive (and safer) therapeutic option in cardiac patients.
Selecting the appropriate strategy will help minimize postoperative morbidity and mortality. A staged operation may be safely performed in which the most symptomatic sub system is the first to be corrected; nonetheless, in those patients with both neurologic and cardiac instability, a combined CEA-CABG can be undertaken with equally satisfactory results.