Does Intensive Management of Cerebral Hemodynamics and Atheromatous Aorta Reduce Stroke After Coronary Artery Surgery?

Stroke Risk After Coronary Artery Bypass Graft Surgery and Extent of Cerebral Artery Atherosclerosis

“…Accordingly, post-CABG stroke developed in none of the 17 patients who had undergone pre-operative carotid stenting in our study. Previous clinical studies have also shown that modification of surgical strategy with respect to the presence of cerebral atherosclerosis may reduce the incidence of post-CABG stroke (11,12). Study limitations.…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…Predictors of ascending aortic atherosclerosis include increasing age, hypertension, extracardiac atherosclerosis (peripheral artery and cerebrovascular disease), and elevated serum creatinine concentrations (853)(854)(855). Prospective RCTs to evaluate the role of epiaortic scanning in assessing stroke risk have not been reported, but several observational studies reported stroke rates of 0 to 1.4% (847)(848)(849)853,856,857) Because the presence of extracranial disease of the internal carotid artery is a risk factor for adverse neurological events after CABG (860), one might argue for use of carotid noninvasive scanning (duplex ultrasonography or noninvasive carotid screening) in all patients scheduled for CABG. At issue is the effectiveness of noninvasive carotid screening in identifying carotid artery stenoses of hemodynamic significance.…”

Prevalência de estenose carotídea em pacientes com indicação de cirurgia de revascularização miocárdica

“…The technical, surgical and anesthetic advancements in cardiac surgery are unquestionable, but the neurological complications, mainly the cerebrovascular accident (CVA) secondary to significant carotid stenosis (SCS), remain a concern for the assistance teams and all strategies must be used to reduce them in the perioperative period [1][2][3] .…”