Prognostic Impact of Asymptomatic Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting

Giuseppe Santarpino, Francesco Nicolini, Marisa De Feo, Magnus Dalén, Theodor Fischlein, Andrea Perrotti, Daniel Reichart, Giuseppe Gatti, Francesco Onorati, Ilaria Franzese, Giuseppe Faggian, Ciro Bancone, Sidney Chocron, Sorosh Khodabandeh, Antonino S. Rubino, Daniele Maselli, Saverio Nardella, Riccardo Gherli, Antonio Salsano, Marco ZanobiniMatteo Saccocci, Karl Bounader, Stefano Rosato, Tuomas Tauriainen, Giovanni Mariscalco, Juhani Airaksinen, Vito G. Ruggieri, Fausto Biancari

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The aim of this study was to evaluate the prognostic impact of untreated asymptomatic carotid artery stenosis (CS) in patients undergoing isolated coronary artery bypass grafting (CABG). Methods: This was a post hoc analysis of data from a prospective multicentre observational study. Patients without history of stroke or transient ischaemic attack from the multicentre E-CABG registry who were screened for CS before isolated CABG were included. Results: Among 2813 patients screened by duplex ultrasound and who did not undergo carotid intervention for asymptomatic CS, 11.1% had a stenosis of 50–59%, 6.0% of 60–69%, 3.1% of 70–79%, 1.4% of 80–89%, 0.5% of 90–99%, and 1.1% had carotid occlusion. In the screened population post-operative stroke occurred in 25 patients (0.9%), with an incidence of 1.5% among patients with CS ≥ 50% (n = 649). Pre-operative screening had not found a relevant CS in 15 of 25 patients suffering stroke after CABG. Brain imaging identified cerebral ischaemic injury in 20 patients, which was bilateral in five patients (25%), ipsilateral to a CS ≥ 50% in six (30%), and ipsilateral to a CS ≥ 70% in three (15%). In univariable analysis, the severity of CS was associated with a significantly increased risk of stroke (CS <50%, 0.7%; 50–59%, 1.0%; 60–69%, 0.6%; 70–79%, 1.2%; 80–89%, 5.1%; 90–99%, 7.7%; occluded, 6.7%, p
Original languageEnglish
Pages (from-to)741-748
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume56
Issue number5
DOIs
Publication statusPublished - Nov 1 2018

Keywords

  • Carotid artery stenosis
  • Coronary artery bypass grafting
  • Stroke

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