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Stroke after coronary artery bypass grafting in patients with cerebrovascular disease

T Hirotani1, T Kameda, T Kumamoto

  • 1Department of Cardiovascular Surgery, Tokyo Saiseikai Central Hospital, Tokyo, Japan. hero.takashi@nifty.ne.jp

The Annals of Thoracic Surgery
|November 28, 2000
PubMed

Insights

Severe carotid artery stenosis is the main predictor of stroke after coronary artery bypass grafting (CABG). Extending prophylactic carotid endarterectomy (CEA) may reduce stroke risk in asymptomatic patients.

Area of Science:

  • Cardiovascular Surgery
  • Neurology
  • Vascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) is associated with increased mortality, particularly from stroke.
  • Identifying stroke predictors in CABG patients is crucial for improving outcomes.

Purpose of the Study:

  • To identify predictors of stroke in patients undergoing CABG.
  • To evaluate the impact of carotid artery stenosis on stroke risk post-CABG.

Main Methods:

  • Data from 472 consecutive CABG patients were analyzed.
  • Extracranial carotid and vertebral arteries were assessed using duplex scanning.
  • Multivariate analysis was used to determine independent predictors of stroke.

Main Results:

  • Postoperative stroke significantly increased mortality by 10-fold (12.5%).
  • Severity of extracranial carotid artery stenosis was the sole independent predictor of stroke (p < 0.01).
  • No strokes occurred in patients with carotid artery occlusion or those who underwent carotid endarterectomy (CEA) before CABG.

Conclusions:

  • Extracranial carotid artery stenosis is a significant risk factor for stroke after CABG.
  • Prophylactic CEA may be beneficial for asymptomatic patients with >75% carotid artery stenosis to reduce stroke incidence.
Abstract

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