The risk of perioperative stroke in patients with asymptomatic carotid bruits undergoing peripheral vascular surgery.
Three hundred patients without neurologic symptoms had 374 elective peripheral vascular procedures and they were screened preoperatively for incidental asymptomatic carotid bruits prior to surgery. The bruits were hemodynamically evaluated with the GEE-OPG. A bruit was considered hemodynamically significant if the OPG test was positive. Seventy-four patients (24.7%, 74/300) were found to have 118 carotid bruits. Twenty-five (22.3%, 25/112) of the 112 bruits with OPG studies were hemodynamically significant. There were three perioperative strokes that occurred for an incidence of 0.8 per cent (3/374). There was no stroke in patients without bruits and with nonhemodynamically significant bruits. The incidence of perioperative stroke in patients with hemodynamically significant bruits was 16 per cent (3/19). There is a subgroup of patients with hemodynamically significant carotid bruits who are at high risk for perioperative stroke.
D000368:Aged; D001314:Auscultation; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D002343:Carotid Artery, Internal; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D006439:Hemodynamics; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D014656:Vascular Surgical Procedures