Is carotid screening redundant for patients undergoing coronary artery bypass grafting?

Journal of Cardiac Surgery
Sara Volpi, Jason M Ali

Abstract

Stroke is a devastating complication following coronary artery bypass grafting, which thankfully occurs with low incidence. The role of preoperative carotid ultrasound remains unclear. Whilst it is a cheap and reliable way of diagnosing carotid stenosis (CS), it is unclear if and how this knowledge should impact on subsequent patient management. A systematic review of the literature was performed using the PRISMA guideline. A literature search was conducted on the MEDLINE database from 1950 to May 2020 using the OVID interface. Fifteen papers out of a total of 5931 were identified for inclusion. The evidence overall suggests that patients with severe CS are likely to have an increased incidence of postoperative stroke-however, the prevalence of severe CS is low, and even in this cohort of patients, the incidence is not particularly high. In screened patients identified to have severe CS, there appears to be a generally low appetite for undertaking carotid intervention internationally either before or concurrently with the coronary artery bypass grafting. Putting this all together, the widespread screening of asymptomatic patients would appear to not be justified.

References

Aug 15, 1991·The New England Journal of Medicine·UNKNOWN North American Symptomatic Carotid Endarterectomy Trial CollaboratorsM Eliasziw
Dec 1, 1990·Journal of Vascular Surgery·G L FaggioliJ J Ricotta
Nov 10, 1988·The New England Journal of Medicine·G L ReedR W DeSanctis
Dec 1, 1996·The Annals of Thoracic Surgery·R S D'AgostinoD M Shahian
Aug 10, 1999·Circulation·C W HogueV G Dávila-Román
Jan 9, 2001·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·G NewJ W Moses
Jan 13, 2001·The Annals of Thoracic Surgery·I FukudaJ Seita
Jul 7, 2001·Stroke; a Journal of Cerebral Circulation·S C StamouP J Corso
May 7, 2002·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·A R NaylorP R F Bell
Aug 14, 2002·The Annals of Thoracic Surgery·Raimondo AscioneGianni D Angelini
Aug 7, 2003·The Annals of Thoracic Surgery·David C CharlesworthUNKNOWN Northern New England Cardiovascular Disease Study Group
Jun 30, 2004·The Annals of Thoracic Surgery·Daniel J DurandDavid D Yuh
Apr 25, 2006·Journal of the American College of Cardiology·Rishi GuptaJay S Yadav
Apr 21, 2007·Clinical Physiology and Functional Imaging·Jacek Nowak, Tomas Jogestrand
Aug 3, 2007·Interactive Cardiovascular and Thoracic Surgery·Lois NwakanmaKonstadinos A Plestis
Dec 25, 2007·American Journal of Surgery·Michiel G van der VaartClark J Zeebregts
Jan 8, 2008·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·E CieriP Cao
Apr 21, 2009·La Presse médicale·Victor Aboyans, Philippe Lacroix
Jul 22, 2009·PLoS Medicine·David MoherUNKNOWN PRISMA Group
Sep 16, 2009·Archives of Neurology·Yuebing LiJohn E Castaldo
Feb 4, 2010·Interactive Cardiovascular and Thoracic Surgery·Rafet GunayMahmut Murat Demirtas
Aug 2, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Karolina DzierwaJerzy Sadowski
Dec 17, 2011·The Journal of Thoracic and Cardiovascular Surgery·L David HillisUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
May 1, 2013·Interactive Cardiovascular and Thoracic Surgery·Fernando HorneroUNKNOWN Working Group on Arrhythmia Surgery and Cardiac Pacing of the Spanish Society for Cardiovascular and Thoracic Surgery (SECTC
Oct 5, 2013·The Annals of Thoracic Surgery·Vikas SharmaLyle D Joyce
Jan 18, 2014·Seminars in Interventional Radiology·Sun Ho AhnGregory J Dubel
Jun 18, 2014·Ultrasonography·Whal Lee
Aug 28, 2015·Revista brasileira de cirurgia cardiovascular : órgão oficial da Sociedade Brasileira de Cirurgia Cardiovascular·Mário Augusto Cray da CostaMarcelo Derbli Schafranski
Nov 21, 2015·The Journal of Thoracic and Cardiovascular Surgery·Khalil MasabniEugene H Blackstone
Feb 26, 2016·The Thoracic and Cardiovascular Surgeon·Molly SchultheisLeonard Lee
Feb 27, 2016·Journal of Vascular Surgery·Judith C LinGaetano Paone
Nov 30, 2016·Cerebrovascular Diseases·Raywat Noiphithak, Anusak Liengudom

❮ Previous
Next ❯

Related Concepts

Related Feeds

Carotid Artery Diseases

Carotid artery disease is a group of pathological conditions of the carotid artery. Discover the latest research on carotid artery disease here.

Related Papers

Annals of Translational Medicine
Victor J Del BruttoTatjana Rundek
Journal of Cardiac Surgery
Ter-Er Kusu-OrkarAmer Harky
The Annals of Otology, Rhinology, and Laryngology
M D MavesM J Keenan
© 2021 Meta ULC. All rights reserved