Document Detail


The role of carotid screening before coronary artery bypass.
MedLine Citation:
PMID:  2243408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Five hundred thirty-nine patients with no symptoms of cerebral ischemia undergoing coronary artery bypass were preoperatively evaluated for presence of carotid stenosis by noninvasive methods (duplex scanning and ocular pneumoplethysmography-Gee). Overall prevalence of carotid stenosis greater than 75% was higher (8.7%) than that generally reported. Age greater than 60 years was significantly related to presence of carotid stenosis greater than 75% (11.3% vs 3.8%, p = 0.003). Risk factors such as hypercholesterolemia, hypertension, diabetes mellitus, and smoking were not predictive for carotid stenosis, postoperative stroke, or death. Carotid stenosis greater than 75% (odds ratio 9.87, p less than 0.005) and coronary artery bypass redo (odds ratio 5.26, p less than 0.05) were both independent predictors of stroke risk. Patients were divided into four groups: group 1, minimal or mild degree of carotid stenosis (less than 50%), not submitted to prophylactic carotid endarterectomy (432 patients, 80.1%); group 2, moderate degree of stenosis (50% to 75%), no prophylactic carotid endarterectomy (60 patients, 11.2%); group 3, severe carotid stenosis; (greater than 75%), submitted to prophylactic carotid endarterectomy (19 patients, 3.5%), group 4, severe carotid stenosis (greater than 75%) no prophylactic carotid endarterectomy (28 patients, 5.2%). Patients in group 4 had significantly higher stroke rate (14.3%) compared to the other three groups (1.1%) (p = 0.0019). The finding of carotid stenosis greater than 75% in patients over 60 years of age was associated with occurrence of stroke in 15% of cases. Carotid screening is helpful to determine patients at increased risk of stroke and should be performed in patients greater than 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
G L Faggioli; G R Curl; J J Ricotta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  12     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1990 Dec 
Date Detail:
Created Date:  1991-01-03     Completed Date:  1991-01-03     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  724-9; discussion 729-31     Citation Subset:  IM    
Affiliation:
Department of Surgery, State University of New York, Buffalo.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carotid Arteries / surgery,  ultrasonography*
Carotid Artery Diseases / epidemiology,  mortality,  surgery,  ultrasonography
Cerebrovascular Disorders / epidemiology,  prevention & control
Coronary Artery Bypass* / mortality
Endarterectomy
Eye / blood supply
Female
Humans
Incidence
Male
Middle Aged
Plethysmography / methods
Postoperative Complications / epidemiology,  prevention & control
Preoperative Care*
Retrospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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