Screening of carotid artery stenosis in coronary artery bypass grafting patients.
BACKGROUND
We sought to evaluate the routine echo-Doppler screening of carotid artery stenosis in patients undergoing coronary artery bypass grafting.


METHODS
A total of 2179 consecutive patients who underwent coronary artery bypass grafting alone or with other cardiac surgery at Tehran Heart Center, Tehran-Iran, between January 2005 and January 2006 were included in this retrospective study. Carotid Doppler was performed for 1604 (81.48%) of these patients.


RESULTS
The patients' age ranged between 20 and 84 years (mean: 58.33, SD: 10.08 years). Of the 1604 patients studied, 1186 (73.9%) were men, 592 (36.9%) had diabetes, 598 (37.3%) were smokers, and 194 (12.1%) cases had significant left main stenosis. Twenty-one (1.3%) patients had significant carotid stenosis (> 60% stenosis), which constituted 0.9% of all the bypass surgery candidates. Post-operative cerebrovascular accident was not detected in any of the patients with significant carotid stenosis, but cerebrovascular accident occurred in 22 (1.4%) of the patients without carotid stenosis. Magnetic resonance angiography (MRA) was conducted in 15 patients. In our univariate analysis, female gender (p value = 0.023), hypertension (p value = 0.055), peripheral vascular disease (p value < 0.001), and age (p value = 0.001) were significant in the development of carotid stenosis.


CONCLUSIONS
Pre-operative duplex carotid screening seems to be necessary in patients when there is hypertension, peripheral vascular disease, female gender, and advanced age.
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Abbas
A
Salehiomran
Shapour
S
Shirani
Abbasali
A
Karimi
Hossein
H
Ahmadi
Mehrab
M
Marzban
Namvar
N
Movahedi
Naghmeh
N
Moshtaghi
Seyed Hesameddin
SH
Abbasi