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July 9, 2010Journal of Cardiac Surgery

Carotid Disease Is a Risk Factor for Stroke in Coronary Bypass Operations

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Key result

Carotid stenosis >60% and reduced cardiac output correlated with perioperative major cerebrovascular events (p<0.01), while prophylactic carotid endarterectomy decreased MCVE incidence (p<0.01).

Why the study?

Does prophylactic carotid endarterectomy or the 'pump off' technique reduce perioperative major cerebrovascular events in patients with carotid stenosis undergoing CABG?

Population

722 consecutive patients undergoing coronary artery bypass grafting who had carotid artery duplex scanning…

Comparison

Prophylactic carotid endarterectomy for patients… vs Standard cardiopulmonary bypass / no…

Design

Cohort

Follow-up

perioperative

Authors

CBCemal Levent BırıncıoğluMBMurat BayazıtAUA. Tulga Ulus

Discussion

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Member takes

Overview

May support prophylactic CEA before CABG in select patients; hypothesis-generating and requires RCTs before changing practice.

Study Design

Type

Observational (n=722)

Structured PICO

Does prophylactic carotid endarterectomy or the 'pump off' technique reduce perioperative major cerebrovascular events in patients with carotid stenosis undergoing CABG?

P
Population
722 consecutive patients undergoing CABG and carotid artery duplex scanning, evaluated for perioperative major cerebrovascular events.
E
Exposure
Prophylactic carotid endarterectomy (CEA) for patients with 80% to 99% carotid stenosis, or 'pump off' technique for patients with 60% to 79% carotid stenosis.
C
Comparator
Standard cardiopulmonary bypass / no prophylactic carotid endarterectomy.
O
Outcome
Perioperative major cerebrovascular events (MCVEs).hard clinical

Main Result

p-value: p=< 0.01

Prophylactic carotid endarterectomy and off-pump CABG may reduce the risk of perioperative major cerebrovascular events in patients with significant carotid stenosis undergoing coronary bypass surgery.

Cite This Study

Bırıncıoğlu et al. (2010) conducted an observational in Coronary artery bypass grafting (CABG) (n=722). Carotid artery stenosis > 60% vs. Carotid stenosis ≤ 60% was evaluated on Perioperative major cerebrovascular events (MCVEs) (p=< 0.01). Carotid stenosis >60% and reduced cardiac output correlated with perioperative major cerebrovascular events (p<0.01), while prophylactic carotid endarterectomy decreased MCVE incidence (p<0.01).

synapsesocial.com/papers/6a982730d08ffd74dfc64670https://doi.org/10.1111/j.1540-8191.1999.tb01270.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Carotid Disease in Patients Scheduled for Coronary Artery Bypass: Analysis of 678 Patients1999 · 34 citations
  2. 2Postoperative Stroke in Cardiac and Peripheral Vascular Disease1980 · 242 citations
  3. 3Beneficial Effect of Carotid Endarterectomy in Symptomatic Patients with High-Grade Carotid Stenosis1991 · 8,505 citations
  4. 4Severity of Aortic Atheromatous Disease Diagnosed by Transesophageal Echocardiography Predicts Stroke and Other Outcomes Associated with Coronary Artery Surgery1996 · 143 citations
  5. 5Carotid duplex sonography: a multicenter recommendation for standardized imaging and Doppler criteria.1988 · 257 citations