Prevalence of carotid stenosis and its correlation with incidence of perioperative stroke in patients of coronary artery bypass graft surgery

Background: Stroke is the most devastating complication of coronary artery bypass graft (CABG) surgery. Presence of carotid stenosis in patients requiring CABG poses a clinical challenge as it increases the risk of stroke during surgery. Present study is retrospective analysis of prevalence of carotid stenosis in Indian patients undergoing CABG surgery and its correlation with incidence of perioperative stroke.

Method: Data of 3700 patients who underwent CABG over a period of 2 years was studied. CT angiography or MR angiography was done in all patients who had >50 % stenosis of internal carotid artery on carotid Doppler study. Incidence of perioperative stroke and its correlation with severe carotid stenosis was analyzed.

Results: One hundred fifty patients were found to have severe carotid stenosis. Twelve patients suffered from perioperative stroke, of which 10 were ischemic in nature. Only one patient with severe carotid stenosis had perioperative stroke. In these patients, also, infarcts were not restricted to stenotic side.

Conclusion: Incidence of perioperative stroke does not depend on severity of carotid stenosis but on number of other risk factors and operative technique.