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In patients undergoing coronary artery bypass surgery, is there benefit from performing preoperative carotid artery screening?
  • Sara Volpi,
  • Jason Ali
Sara Volpi
Royal Papworth Hospital
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Jason Ali
Royal Papworth Hospital
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Abstract

Stroke is a devastating complication following coronary artery bypass grafting, which thankfully occurs with low incidence. The role of preoperative carotid ultrasound remains unclear. Whilst it is a cheap and reliable way of diagnosing carotid stenosis, it is unclear if and how this knowledge should impact on subsequent patient management. The evidence overall suggests that patients with severe carotid stenosis are likely to have an increased incidence of postoperative stroke -- however, the prevalence of severe carotid stenosis is low, and even in this cohort of patients, the incidence is not particularly high. In screened patients identified to have severe carotid stenosis, there appears to be a generally low appetite for undertaking carotid intervention internationally either prior to or concurrently with the coronary artery bypass grafting. Putting this all together, the widespread screening of asymptomatic patients would appear to not be justified.

Peer review status:ACCEPTED

30 Apr 2020Submitted to Journal of Cardiac Surgery
02 May 2020Submission Checks Completed
02 May 2020Assigned to Editor
05 May 2020Reviewer(s) Assigned
20 May 2020Review(s) Completed, Editorial Evaluation Pending
21 May 2020Editorial Decision: Revise Major
22 May 20201st Revision Received
23 May 2020Submission Checks Completed
23 May 2020Assigned to Editor
23 May 2020Reviewer(s) Assigned
03 Jun 2020Review(s) Completed, Editorial Evaluation Pending
04 Jun 2020Editorial Decision: Accept