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July 1, 1981StrokeOpen Access

Asymptomatic carotid disease in the cardiovascular surgical patient: is prophylactic endarterectomy necessary?

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Key result

Asymptomatic carotid occlusive disease did not predispose to perioperative stroke, though perioperative mortality was higher in patients with detectable obstruction compared to those without (15.0% vs 3.1%).

Why the study?

Does asymptomatic carotid occlusive disease predispose to perioperative stroke in patients undergoing cardiovascular surgery without prophylactic carotid endarterectomy?

Population

314 patients scheduled for coronary or peripheral arterial reconstruction, screened for asymptomatic carotid…

Comparison

No prophylactic carotid endarterectomy vs Patients without carotid obstruction or bruit

Design

Cohort

Follow-up

perioperative

Authors

RBRobert W. BarnesPMPhyllis B. Marszalek

Discussion

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Overview

Does not support routine prophylactic endarterectomy; leaves open whether obstruction drives excess perioperative mortality.

Study Design

Type

Cohort (n=314)

Structured PICO

Does asymptomatic carotid occlusive disease predispose to perioperative stroke in patients undergoing cardiovascular surgery without prophylactic carotid endarterectomy?

P
Population
314 patients scheduled for coronary or peripheral arterial reconstruction screened for asymptomatic carotid occlusive disease.
E
Exposure
No prophylactic carotid endarterectomy (observational management)
C
Comparator
Patients without carotid obstruction or bruit
O
Outcome
Perioperative stroke and transient ischemic attack (TIA)hard clinical

Main Result

Absolute Event Rate: 15% vs 3.1%

Asymptomatic carotid occlusive disease does not necessarily predispose to perioperative stroke during cardiovascular surgery, suggesting prophylactic carotid endarterectomy may not be necessary.

Cite This Study

Barnes et al. (1981) conducted a cohort in Cardiovascular surgical patients (coronary or peripheral arterial reconstruction) (n=314). Asymptomatic carotid occlusive disease vs. No carotid obstruction was evaluated on Perioperative mortality. Asymptomatic carotid occlusive disease did not predispose to perioperative stroke, though perioperative mortality was higher in patients with detectable obstruction compared to those without (15.0% vs 3.1%).

synapsesocial.com/papers/6a9cfdadccf76bb89d97aff0https://doi.org/10.1161/01.str.12.4.497
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Also Consider

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

  1. 1Postoperative Stroke in Cardiac and Peripheral Vascular Disease1980 · 242 citations
  2. 2Carotid Endarterectomy1978 · 57 citations
  3. 3Noninvasive Evaluation of the Carotid Bruit1980 · 15 citations
  4. 4Prophylactic Carotid Artery Surgery in Patients Requiring a Second Operation1974 · 27 citations
  5. 5Carotid Artery Stenosis1972 · 178 citations