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Carotid bruit: a follow-up report on its significance in patients undergoing an abdominal aortic operation

R L Treiman, R F Foran, J L Cohen

    Archives of Surgery (Chicago, Ill. : 1960)
    |October 1, 1979
    PubMed

    Insights

    Elective abdominal aortic operations did not show a correlation between carotid bruits and postoperative stroke. Routine carotid angiography and surgery for patients with carotid bruits undergoing aortic surgery are questioned.

    Area of Science:

    • Vascular Surgery
    • Cerebrovascular Disease
    • Aortic Aneurysm

    Background:

    • Patients undergoing elective abdominal aortic operations for aneurysmal or occlusive disease are at risk for cerebrovascular events.
    • The presence of a carotid bruit or a history of cerebral ischemia may indicate underlying cerebrovascular disease.
    • Prophylactic carotid endarterectomy is sometimes considered in patients with carotid bruits.

    Purpose of the Study:

    • To investigate the correlation between carotid bruits, history of cerebral ischemia, and postoperative stroke in patients undergoing elective abdominal aortic operations.
    • To evaluate the necessity of routine carotid angiography and surgery in patients with carotid bruits undergoing abdominal aortic surgery.

    Main Methods:

    • Retrospective review of 516 patient records undergoing elective abdominal aortic operations.
    • Analysis of patient data including presence of carotid bruit, history of cerebral ischemia, and postoperative stroke.
    • Statistical assessment for correlation between pre-existing conditions and stroke occurrence.

    Main Results:

    • Four patients (0.8%) experienced a postoperative stroke.
    • No significant correlation was found between the presence of a carotid bruit and postoperative stroke.
    • No significant correlation was found between a history of cerebral ischemic symptoms and postoperative stroke.

    Conclusions:

    • The presence of a carotid bruit or a history of cerebral ischemia in patients undergoing elective abdominal aortic operations does not appear to predict postoperative stroke.
    • Routine carotid angiography and prophylactic surgery based solely on the presence of a carotid bruit in patients undergoing abdominal aortic operations may not be indicated.

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