Impact of Preoperative Ultrasonography Screening for Carotid Artery Stenosis in Lung Cancer Patients

Fukushima, Shoji; Takeo, Sadanori; Yamazaki, Koji; Miura, Naruhisa; Katsura, Masakazu; Oku, Yuka; Shimokawa, Mototsugu

doi:10.1016/j.athoracsur.2018.04.072

Cited by 2 publications

(4 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sex ratio was the only difference we recorded between patients with and without carotid DUS, but an impact of this bias on our results cannot be totally excluded. Secondly, our series is characterized by a high proportion of patients with LEAD (15%) whereas LEAD is reported in grossly 3-4.5% of patients undergoing lung cancer resection in the published series (6,20,22). This may be explained by a high rate of smokers (90%) in our series, and especially of heavy smokers as reflected by a mean pack/year of 44.…”

Section: Limitations Of the Studymentioning

confidence: 73%

“…In the present study, only 3.5% of patients had stenosis >50%. In other studies, carotid stenosis was diagnosed in 7% (stenosis >50%) and 8% ("critical unilateral carotid stenosis without compensatory circuit or evidence of irregular potentially embolising atheromatous plaque") of surgical lung cancer patients (20,22). Similarly, before cardiovascular surgery, 7% of patients had >70% stenosis (23).…”

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 93%

“…The 307 patients with carotid DUS represent a large proportion (77%) of all patients who had undergone a lung resection for cancer in our institution over a period during which a preoperative carotid DUS was systematically offered. This low fraction of patients whose preoperative management has been modified may be partially explained by the fact that before lung cancer detection, 27% and 7% of patients were treated with anti-platelet agent and anticoagulant, respectively, a proportion close to that reported in a previous series (20). Recent guidelines emphasized that carotid imaging is not indicated routinely before noncardiac surgery procedures (13).…”

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 96%

“…In our series, 3% of patients had a history of stroke, and 3% of TIA, respectively. In a recent study, 3% of 1,676 surgical lung cancer patients had a history of stroke (20). In addition, since surgical patients are highly selected, it is important to consider all lung cancer patients, regardless of their treatment : in a population-based registry including 3,864 lung cancer patients, only 2-3% of patients <70 yr and 5-7% of patients >70 yr had a history cerebrovascular accident (21).…”

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 99%

See 3 more Smart Citations

Should we screen patients for carotid artery disease before lung cancer resection?

Charloux¹,

Matau²,

Jégu³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

Background: Postoperative stroke is a rare complication after lung cancer surgery but has a high mortality rate. No strategy has been recommended to detect carotid artery disease preoperatively in lung cancer patients. The main objective of this study was to evaluate whether a routine carotid duplex ultrasound (DUS) altered the preoperative management of these patients. Methods: We performed a single-centre, retrospective study of all patients referred for lung cancer resection over a two-year period and reviewed the available carotid DUS results. We quantified the number of carotid artery disease diagnosis, the severity of the disease according to DUS results, and the number of treatments initiated preoperatively. We examined relationships between cardiovascular history and preoperative carotid artery disease diagnosis. Results: Among the 398 consecutive lung surgery patients, 6% had a preoperative history of stroke or transient ischemic attack, and one developed a postoperative stroke, of cardioembolic origin. Three hundred and seven patients (77%) had preoperative carotid DUS. Carotid DUS results elicited anti-platelet therapy initiation or endarterectomy before lung resection in 7 out of these 307 patients (2.3%). One hundred and seventy-one carotid DUS were retrospectively reviewed by an expert, who diagnosed carotid stenosis >50% and occlusion in 2.3% and 1.2% of patients, respectively. Abnormal carotid DUS was associated with history of lower extremity artery disease (P<0.001), diabetes mellitus (P<0.05) and dyslipidemia (P<0.05). Conclusions: This retrospective observational study showed that routine preoperative carotid DUS led to few carotid stenosis detection and few perioperative management alterations. Carotid artery disease diagnosis was associated with cardiovascular history and risk factors. Future studies should examine how to select patients who will benefit from a preoperative carotid DUS.

show abstract

Section: Limitations Of the Studymentioning

confidence: 73%

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 93%

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 96%

Section: Relationships Between Medical History and Carotid Dus Results (171 Reviewed Carotid Ultrasonography)mentioning

confidence: 99%

See 2 more Smart Citations

Should we screen patients for carotid artery disease before lung cancer resection?

Charloux¹,

Matau²,

Jégu³

et al. 2020

J Thorac Dis

View full text Add to dashboard Cite

show abstract

Operability boundaries in pancreatic cancer: what is the limit?

et al. 2019

View full text Add to dashboard Cite

Preoperative diagnosis of comorbidities is essential for identifying the limiting factors inperioperative period and correct assessment of patient’s ability to undergo surgery. Severe concomitant diseases followed by advanced risk of adverse events require development and implementation of the strategy of preoperative preparation of patient. These measuress hould include both medicamentous and surgical correction of concomitant diseases in order to reduce perioperative risks. Thus, multidisciplinary perioperative approach makes it possible to reduce significantly the risks and mortality in patients undergoing surgery for pancreatic cancer. Diagnosis and correction of limiting factors approach operability to absolute one. However, operation should be avoided or alternative approaches should be preferred if co-morbidities are significant and failed to be corrected.

show abstract

Impact of Preoperative Ultrasonography Screening for Carotid Artery Stenosis in Lung Cancer Patients

Cited by 2 publications

References 20 publications

Should we screen patients for carotid artery disease before lung cancer resection?

Should we screen patients for carotid artery disease before lung cancer resection?

Operability boundaries in pancreatic cancer: what is the limit?

Contact Info

Product

Resources

About