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[Carotid screening with duplex scanning before coronary artery bypass]
1Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Ibaraki, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|April 1, 1996
Summary
Carotid duplex scans effectively identify stenosis in coronary artery bypass patients. Screening helps manage risks, preventing strokes and deaths during surgery.
Area of Science:
- Vascular Surgery
- Neurology
- Cardiology
Background:
- Coronary artery bypass grafting (CABG) candidates may have undiagnosed carotid artery disease.
- Cerebrovascular events are a significant risk during and after CABG surgery.
- Preoperative screening for carotid stenosis is crucial for risk stratification.
Purpose of the Study:
- To evaluate the prevalence of carotid stenosis in patients scheduled for CABG.
- To identify risk factors associated with carotid stenosis in this population.
- To assess the utility of duplex scanning for preoperative carotid evaluation.
Main Methods:
- Seventy-one patients undergoing scheduled CABG were preoperatively screened using carotid duplex scanning.
- Stenosis severity was classified based on peak systolic flow velocity (PSV) of the internal carotid artery.
- Duplex scan findings were compared with carotid angiogram results for critical stenosis cases.
Main Results:
- A moderate to high degree of carotid stenosis was detected in 12.7% of patients.
- Diabetes mellitus and a history of stroke were identified as predictive risk factors.
- Duplex scanning accurately identified critical stenosis (>90%), with no operative deaths or strokes in treated patients.
Conclusions:
- Carotid duplex scanning is a valuable tool for detecting carotid occlusive disease in CABG candidates.
- Early detection allows for appropriate management, including further hemodynamic assessment and intraoperative brain protection.
- Proactive screening can mitigate the risk of perioperative stroke in patients undergoing coronary artery bypass.