Staged carotid artery stenting followed by coronary artery bypass graft surgery in a patient with bilateral severe asymptomatic carotid artery stenosis, shaggy aorta, and severe renal dysfunction: a case report

Abstract

Objective: We report on a case of staged carotid artery stenting (CAS) for bilateral severe asymptomatic carotid artery stenosis followed by coronary artery bypass grafting (CABG) in a patient with unstable angina pectoris.
Case presentation: A 60-year-old male patient suffering from unstable angina pectoris with triple-vessel coronary artery disease was diagnosed with bilateral severe asymptomatic carotid artery stenosis before CABG. Due to severe atherosclerosis of the aorta (shaggy aorta) and severe renal dysfunction, a right CAS was performed via the trans-brachial arterial approach under ultrasound guidance to eliminate the need for iodine contrast use, and a left CAS was performed via direct puncture to minimize iodine contrast.
Conclusion: We reported the strategy and ingenuity of CAS for a pre-CABG patient with shaggy aorta, renal dysfunction and subclavian artery dissection.