[Ultrasound carotid artery plaque morphology and perioperative stroke risk in patients undergoing coronary artery bypass grafting].
OBJECTIVE
To determine the influence of carotid artery plaque (CAP) morphology on perioperative stroke in coronary artery bypass grafting (CABG).


METHODS
Ninety-three patient undergoing CABG were studied. CAPs and other lesions including intima-media thickness (IMT) and stenosis were examined by using ultrasound imaging. CAPs were morphologically classified as either homogeneous (HmP) or heterogeneous (HtP).


RESULTS
Mean and max IMT were 1.26 +/- 0.15 and 2.44 +/- 0.76 mm. Mean total plaque score was 15.75 +/- 6.82. HmP and HtP were seen in 80 (86.0%) and 54 (58.1%) patients. Stenosis greater than 50% was found in 22 (23.7%) patients. HtP was significantly associated with age (p<0.05), diabetes and severity of coronary artery disease (p<0.01) and stenosis was associated with diabetes and history of cerebrovascular events (p <0.05). Late postoperative stroke occurred in 3 (3.2%) patients during hospitalization. One of them had 90% stenosis in the carotid artery. The others had no carotid stenosis. In all of the 3, the predominant plaques were heterogeneous.


CONCLUSIONS
CAP morphology in patients undergoing CABG was detailed. As well as stenotic lesion, plaque heterogeneity may be a risk factor for perioperative stroke. Diabetes is associated with severity of both plaque heterogeneity and stenosis.
Aoki
K
K
Department of Cardiovascular Surgery, Nagaoka Red Cross Hospital, Nagaoka, Japan.
Sugawara
M
M
Hirahara
H
H
Togashi
K
K
Oguma
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012306:Risk; D020521:Stroke / Q000209:etiology*; D014463:Ultrasonography