同时患有颈动脉和冠状动脉疾病的患者应先行颈动脉内膜切除术或支架置入术吗？

Carotid endarterectomy or stenting before coronary artery bypass in patients with coexisting carotid and coronary disease？

颈动脉与冠状动脉粥样硬化性病变常常并存。如何处理这2种病变，特别是为了降低围手术期卒中风险，是否有必要在冠状动脉旁路移植术前或同时对颈动脉病变进行治疗，在治疗颈动脉时支架置入血管成形术是否可取代颈动脉内膜切除术等，一直存在争论。文章就此进行了讨论。

Carotid artery and coronary atherosclerotic lesions often coexist. How to manage the two kinds of lesions, especially to reduce the risk of perioperative stroke, whether it is necessary to treat carotid artery lesions first or simultaneously before coronary artery bypass grafting, and whether stent angioplasty can replace carotid endarterectomy in the treatment of carotid disease has been controversial, This article discusses them.