Does preoperative carotid stenosis screening reduce perioperative stroke in patients undergoing coronary artery bypass grafting?

Khalil Masabni, Sajjad Raza, Eugene H. Blackstone, Heather L. Gornik, Joseph F. Sabik

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)

Abstract

Abstract A number of institutions routinely perform carotid artery ultrasound screening before coronary artery bypass grafting (CABG) to identify carotid artery disease requiring revascularization before or during CABG, with the expectation of reducing perioperative neurologic events. The assumptions are that carotid disease is causally related to perioperative stroke and that prophylactic carotid revascularization decreases the risk of post-CABG neurologic events. Although carotid artery stenosis is a known risk factor for perioperative stroke in patients undergoing CABG, it might be a surrogate marker for diffuse atherosclerotic disease rather than a direct etiologic factor. Moreover, the benefit of prophylactic carotid revascularization in patients with asymptomatic unilateral carotid disease is uncertain. Therefore, we have reviewed the literature for evidence that preoperative carotid artery screening, by identifying patients with significant carotid artery stenosis and altering their management, reduces perioperative neurologic events in those undergoing CABG.

Original languageEnglish
Article number9352
Pages (from-to)1253-1260
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume149
Issue number5
DOIs
Publication statusPublished - 1 May 2015
Externally publishedYes

Keywords

  • carotid stenosis screening
  • coronary artery bypass grafting
  • stroke

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