Is Carotid Artery Disease Responsible for Perioperative Strokes After Coronary Artery Bypass Surgery?

Publication/Presentation Date

12-2010

Abstract

The coronary and extracranial carotid vascular beds are often simultaneously affected by significant atherosclerotic disease, and stroke is one of the potential major complications of coronary artery surgery. As a result, there is no shortage of reports in the vascular surgery literature describing simultaneous coronary and carotid artery revascularizations. Generally, these reports have found this combination of operations safe, but have stopped short of proving that it is necessary. Intuitively, simultaneous carotid endarterectomy and coronary artery bypass surgery could be justified if most perioperative strokes were the result of a significant carotid stenosis, either directly or indirectly. At first glance this appears to be a fairly straightforward issue; however, much of the evidence on both sides of the argument is circumstantial. One significant problem in analyzing outcome by choice of treatment in patients presenting with both coronary and carotid disease is the multiple potential causes of stroke in coronary bypass patients, which include hemorrhage and atheroemboli from aortic atheromas during clamping. But this controversial subject is now open to discussion, and our debaters have been given the challenge to clarify the evidence to justify their claims.

Volume

52

Issue

6

First Page

1716

Last Page

1721

ISSN

1097-6809

Disciplines

Cardiology | Diseases | Medical Sciences | Medical Specialties | Medicine and Health Sciences | Neurology | Surgery

PubMedID

21146753

Department(s)

Department of Medicine, Cardiology Division

Document Type

Article

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