Preoperative carotid artery screening in elderly patients undergoing cardiac surgery

Berens, Eric S.; Kouchoukos, Nicholas T.; Murphy, Suzan F.; Wareing, Thomas H.

doi:10.1016/0741-5214(92)90253-5

Cited by 149 publications

(93 citation statements)

References 19 publications

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“…The prevalence of carotid stenosis ≥ 50% in patients undergoing cardiac surgery (CABG; CABG + valve surgery) ranges from 3.8% to 22%. [15][16][17][18][19][20] The presence of significant (≥ 70%) internal carotid artery stenosis in our Correlates of carotid stenosis in CABG patients 235 study was 7.7%. Selectively screening patients with carotid artery DUS, as opposed to screening every patient > 65 years old, would provide a more streamlined and cost-effective approach to carotid DUS prior to CABG.…”

Section: Discussionmentioning

confidence: 99%

Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting – a case control study

et al. 2009

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Carotid duplex ultrasonography (DUS) is routinely performed prior to coronary artery bypass graft surgery (CABG) on all patients > 65 years old because of the reported associated risk of finding concomitant carotid artery stenosis. Identifying risk factors that correlate with severe carotid stenosis may result in more costeffective screening for patients with asymptomatic carotid artery disease prior to CABG. We performed a retrospective study to identify risk factors for significant carotid artery disease in patients scheduled to undergo CABG between March 2005 and March 2008 at the Massachusetts General Hospital. Patients with carotid stenosis ≥ 70% identified by DUS (n = 50) were matched by age and sex to control patients who had < 50% stenosis (n = 50). Data were analyzed using the chi-squared test or analysis of variance as appropriate. Logistic regression was used to examine multivariate correlates of carotid stenosis. A total of 643 patients were screened to arrive at the patient cohorts described below. This produced a prevalence of 7.7% for significant (> 70%) carotid disease. The patient cohorts were predominantly male with no significant difference in the incidence of diabetes, hypertension, extent of coronary artery disease (CAD) (i.e. left main coronary artery disease (LMCA) and one, two-, or three-vessel CAD) or lipid abnormalities in the two groups. Univariate analysis identified the presence of peripheral arterial disease (PAD, p = 0.001), a cervical bruit (p < 0.0001), a prior neurological event (p = 0.020), and the presence of an abdominal aortic aneurysm (AAA; p = 0.046) as significant predictors of ≥ 70% internal carotid artery stenosis. Logistic regression analysis revealed that the presence of a carotid bruit (p = 0.0068) and PAD (p = 0.0194) were associated with an increased risk of significant carotid artery disease. In conclusion, the presence of a carotid bruit or PAD predicts an increased likelihood of significant carotid artery disease in patients undergoing CABG. Unlike previous studies, LMCA or extent of CAD did not correlate with significant carotid artery disease. Using these predictive models, a prospective outcomes trial is required to validate these criteria.

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Section: Discussionmentioning

confidence: 99%

Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting – a case control study

et al. 2009

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“…Berens ve ark. [31] ise olguların %17'sinde %50 ve üzerin-de, %5.9'unda ise %80'in üzerinde karotis arter stenozu bildirmişlerdir. Çalışmamızda ise olguların %9'unda %50-69 arasında, %3.7'sinde ≥%70 stenoz ve %2.7'sinde ise karotis arter oklüzyonu tespit edildi.…”

Section: Discussionunclassified

“…En önemli risk faktörünün karotis arter stenozu olduğu, diğer risk faktörlerinin ise ileri yaş, cinsiyet, DM, hipertansiyon, sigara kullanım öyküsü, geçirilmiş geçici iskemik atak ya da iskemik inme öyküsü, geçirilmiş Mİ ve AKA stenozu ile hastalıklı koroner arter sayısı olduğu bildirilmiştir. [5,22,25,26,31] Karotis arter stenozu ile ameliyat sonrası inme arasındaki ilişkiyi araştıran birçok çalış-ma yapılmış ve anlamlı karotis arter stenozunun inme riskini belirgin şekilde artırdığı tespit edilmiştir. [25,31,33] Salasidis ve ark.…”

Section: Discussionunclassified

“…[5,22,25,26,31] Karotis arter stenozu ile ameliyat sonrası inme arasındaki ilişkiyi araştıran birçok çalış-ma yapılmış ve anlamlı karotis arter stenozunun inme riskini belirgin şekilde artırdığı tespit edilmiştir. [25,31,33] Salasidis ve ark. [28] %80 ve üzerinde stenozu olan hastalarda inme riskini %18.2, %80 ve altında ise %1.7, Hirotani ve ark.…”

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Comparison of the incidences of carotid artery lesion and vertebrobasilary insufficiency with incidence of postoperative stroke in patients who undergo coronary artery bypass graft surgery

Ülger¹

2011

Turkish J Thorac Cardiovasc Surg

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“…Therefore, screening programs in CABG candidates may identify from 2.8% to 8.7% of the patients with signifi cant carotid lesion (≥ 75%) [28][29][30][31][32][33] .…”

Section: Surgical Indication and Techniquementioning

confidence: 99%

Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

Lucas

Bonamigo

Weber

et al. 2005

Arq. Bras. Cardiol.

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Preoperative carotid artery screening in elderly patients undergoing cardiac surgery

Cited by 149 publications

References 19 publications

Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting – a case control study

Correlates of carotid stenosis in patients undergoing coronary artery bypass grafting – a case control study

Comparison of the incidences of carotid artery lesion and vertebrobasilary insufficiency with incidence of postoperative stroke in patients who undergo coronary artery bypass graft surgery

Procedimento combinado entre operação de revascularização do miocárdio e endarterectomia de carótida: análise dos resultados

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