title: Influence of carotid artery stenosis on stroke in patients undergoing off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  It is well known that the presence of carotid artery stenosis increases the risk of perioperative stroke in patients undergoing cardiac surgery with cardiopulmonary bypass. Although off-pump coronary artery bypass grafting (CABG) can avoid the adverse effects of cardiopulmonary bypass, the influence of carotid artery stenosis on the incidence of stroke in patients undergoing off-pump CABG has not been well clarified.
  
  
  METHODS
  We conducted a retrospective study of 461 patients who underwent elective off-pump CABG after screening for carotid artery stenosis at our institute between September 2004 and May 2007. The incidence and etiologies of stroke were identified. Preoperative screening revealed significant carotid artery stenosis in 49 patients. Clinical results were compared between patients with and without carotid artery stenosis.
  
  
  RESULTS
  Postoperative stroke occurred in two (0.43%) of the 462 study patients, and in-hospital mortality occurred in three (0.65%). Stroke was due to decreased perfusion resulting from hypovolemic shock in one and thrombosis in the other. There was neither stroke nor in-hospital mortality in patients with carotid artery stenosis, although there were two strokes (0.49%) and three in-hospital mortalities (0.73%) in patients without carotid artery stenosis.
  
  
  CONCLUSIONS
  The influence of carotid artery stenosis on the incidence of perioperative stroke may be little in off-pump CABG, especially in patients with moderate carotid artery stenosis.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute, Fuchu, Tokyo 183-0003, Japan. s-manabe@fb3.so-net.ne.jp
authors.forename: Susumu
authors.initials: S
authors.lastname: Manabe
authors.forename: Tomoki
authors.initials: T
authors.lastname: Shimokawa
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Fukui
authors.forename: Ken-u
authors.initials: KU
authors.lastname: Fumimoto
authors.forename: Naomi
authors.initials: N
authors.lastname: Ozawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Seki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ikenaga
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D016894:Endarterectomy, Carotid / Q000379:methods; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome