Routine Preoperative Carotid Duplex Scanning in Patients Undergoing Open Heart Surgery: Is It Worthwhile?

Ascher, Enrico; Hingorani, Anil; Yorkovich, William; Ramsey, Philip J.; Salles-Cunha, Sérgio X.

doi:10.1007/s10016-001-0088-6

Cited by 45 publications

(37 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients undergoing coronary revascularization are another group with an increased prevalence of carotid stenosis of 2% to 27%. 37,38 Overall, the prevalence of carotid artery stenosis among patients undergoing CABG is higher than the general population. In patients with symptomatic CAD and other risk factors, such as age Ͼ65 years, history of stroke or TIA, left main coronary stenosis, diabetes mellitus, carotid bruit, peripheral arterial disease (PAD), and previous carotid operation, it is feasible that a subset of patients with a prevalence Ͼ20% can be identified who might benefit from carotid screening.…”

Section: B Indications For Imaging the Neurologically Asymptomatic Pmentioning

confidence: 98%

“…In patients with symptomatic CAD and other risk factors, such as age Ͼ65 years, history of stroke or TIA, left main coronary stenosis, diabetes mellitus, carotid bruit, peripheral arterial disease (PAD), and previous carotid operation, it is feasible that a subset of patients with a prevalence Ͼ20% can be identified who might benefit from carotid screening. 37,[39][40][41][42][43][44][45] The ACC/AHA guidelines 46 note that carotid screening before CABG is probably indicated in the following subset of patients: age Ͼ65 years, left main coronary stenosis, history of smoking, history of TIA/stroke or carotid bruit, and PAD.…”

Section: B Indications For Imaging the Neurologically Asymptomatic Pmentioning

confidence: 99%

See 1 more Smart Citation

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Ricotta

AbuRahma

Ascher

et al. 2011

Journal of Vascular Surgery

Self Cite

569

536

View full text Add to dashboard Cite

Management of carotid bifurcation stenosis is a cornerstone of stroke prevention and has been the subject of extensive clinical investigation, including multiple controlled randomized trials. The appropriate treatment of patients with carotid bifurcation disease is of major interest to the community of vascular surgeons. In 2008, the Society for Vascular Surgery published guidelines for treatment of carotid artery disease. At the time, only one randomized trial, comparing carotid endarterectomy (CEA) and carotid stenting (CAS), had been published. Since that publication, four major randomized trials comparing CEA and CAS have been published, and the role of medical management has been re-emphasized. The current publication updates and expands the 2008 guidelines with specific emphasis on six areas: imaging in identification and characterization of carotid stenosis, medical therapy (as stand-alone management and also in conjunction with intervention in patients with carotid bifurcation stenosis), risk stratification to select patients for appropriate interventional management (CEA or CAS), technical standards for performing CEA and CAS, the relative roles of CEA and CAS, and management of unusual conditions associated with extracranial carotid pathology. Recommendations are made using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system, as has been done with other Society for Vascular Surgery guideline documents.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be<3% to ensure benefit for the patient. CAS should be reserved for symptomatic patients with stenosis of 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as the first-line therapy.

show abstract

Section: B Indications For Imaging the Neurologically Asymptomatic Pmentioning

confidence: 98%

Section: B Indications For Imaging the Neurologically Asymptomatic Pmentioning

confidence: 99%

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Ricotta

AbuRahma

Ascher

et al. 2011

Journal of Vascular Surgery

Self Cite

569

536

View full text Add to dashboard Cite

show abstract

“…Duplex sonography constitutes the most common imaging method for screening patients undergoing major vascular and cardiac surgery [7][8][9][10], but has drawbacks due to technical difficulties, overestimation of lesions in cases of bilateral disease [11], and problems in evaluating occlusions and complex anatomy [12] may be exacerbated by the characteristic abnormalities in flow velocity pattern due, for example, to an aortic stenosis with increased acceleration time, decreased peak velocity and a delayed upstroke [13]. Moreover, true ultrasound imaging is sometimes impended by extensive calcification and the examination is insufficient in maximally 5% of patients with high grade stenosis.…”

Section: Carotid Artery Angiographymentioning

confidence: 99%

Screening angiography of supraaortic vessels performed by invasive cardiologists at the time of cardiac catheterization: indications and results

Rigatelli¹,

Rigatelli²

2005

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

An aging population makes multiple vascular distributions more likely in patients arriving at the cath lab for coronary artery angiography or complete cardiac catheterization. Whether or not screening angiography of supraaortic vessels can be performed at the time of cardiac catheterization by the invasive cardiologist is still debatable. We sought to determine safety and utility of performing angiography of supraaortic vessels during cardiac catheterization. Medical records of all patients undergoing combined coronary and noncoronary angiography between May 1998 and December 2002 was retrospectively reviewed. One hundred and forty patients (80 males, mean age 67.8 +/- 5.4 years) underwent combined cardiac catheterization and angiography of supraaortic vessels. Carotid artery angiography was performed at the same time of cardiac catheterization in 62 patients and subclavian artery angiography in the other 78 patients. Significant findings were reported in 32 (22.8%) patients. Complications included 1 transient ischemic attack and 2 carotid spasm resolved with nitrates infusion. In most cases the same standard catheters used during coronary angiography were used also for noncoronary angiography (119 patients, 85%). The incidence of significant angiographic findings and the relatively frequent association of CAD with supraaortic vessel atherosclerosis supports combined cardiac catheterization and angiography of supraaortic arteries but only in patients with multivessel coronary artery disease.

show abstract

“…[3][4][5]7 Previous studies addressed the benefits of carotid screening in patients awaiting CABG, heart valve surgery, or both. 8 It has also been reported that carotid screening is cost-effective in patient populations in which the incidence of severe carotid stenosis exceeds 4.5%. 9 The aim of this study is to assess the yield of screening for asymptomatic carotid artery disease by duplex scanning prior to IHVS.…”

Section: Introductionmentioning

confidence: 99%

Selective Screening for Asymptomatic Carotid Artery Disease Prior to Isolated Heart Valve Surgery

Zayed¹,

Ali²,

Wendler³

et al. 2008

Angiology

View full text Add to dashboard Cite

show abstract

Routine Preoperative Carotid Duplex Scanning in Patients Undergoing Open Heart Surgery: Is It Worthwhile?

Cited by 45 publications

References 35 publications

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Updated Society for Vascular Surgery guidelines for management of extracranial carotid disease

Screening angiography of supraaortic vessels performed by invasive cardiologists at the time of cardiac catheterization: indications and results

Selective Screening for Asymptomatic Carotid Artery Disease Prior to Isolated Heart Valve Surgery

Contact Info

Product

Resources

About