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Titolo:
CAROTID-ARTERY DUPLEX SCANNING IN PREOPERATIVE ASSESSMENT FOR CORONARY-ARTERY REVASCULARIZATION - THE ASSOCIATION BETWEEN PERIPHERAL VASCULAR-DISEASE, CAROTID-ARTERY STENOSIS, AND STROKE
Autore:
SALASIDIS GC; LATTER DA; STEINMETZ OK; BLAIR JF; GRAHAM AM; BRENER BJ; CALLIGARO KD; RILES TS; YOUKEY JR; BABU SC; VEITH FJ;
Indirizzi:
ROYAL VICTORIA HOSP,687 PINE AVE W,SUITE S830 MONTREAL PQ H3A 1A1 CANADA MCGILL UNIV,DEPT SURG MONTREAL PQ CANADA
Titolo Testata:
Journal of vascular surgery
fascicolo: 1, volume: 21, anno: 1995,
pagine: 154 - 162
SICI:
0741-5214(1995)21:1<154:CDSIPA>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC-SURGERY; CARDIOVASCULAR-SURGERY; ASYMPTOMATIC PATIENTS; BYPASS OPERATIONS; RISK; ENDARTERECTOMY; EXPERIENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
24
Recensione:
Indirizzi per estratti:
Citazione:
G.C. Salasidis et al., "CAROTID-ARTERY DUPLEX SCANNING IN PREOPERATIVE ASSESSMENT FOR CORONARY-ARTERY REVASCULARIZATION - THE ASSOCIATION BETWEEN PERIPHERAL VASCULAR-DISEASE, CAROTID-ARTERY STENOSIS, AND STROKE", Journal of vascular surgery, 21(1), 1995, pp. 154-162

Abstract

Purpose: The purpose of this study was to identify high-risk populations for severe carotid artery disease (SCD) and neurologic events (NE)after nonemergency isolated coronary artery bypass graft procedures (CABG). Methods: Between February 1989 and July 1992, 387 patients underwent preoperative carotid artery duplex scanning as part of a preoperative assessment for nonemergency cardiac procedures. Of these patients, 376 had isolated CABG, and 11 had combined carotid endarterectomy (CEA) and CABG. Patient demographics, risk factors, and preoperative neurologic symptoms were recorded and analyzed. Severe carotid artery disease was defined as a 80% or greater stenosis of either internal carotid artery by carotid artery duplex scanning. Patients were evaluated for neurologic events (cerebrovascular accident, transient ischemic attack, amaurosis fugax, or reversible ischemic neurologic deficits) during the in-hospital postoperative period. Results: The prevalence of SCD was 8.5% (33 patients). The 33 patients with SCD were significantlyolder (65.6 +/- 6.5 years vs 62.5 +/- 10.4 years,p = 0.02), had previous CEA (27.3% vs 2.0%, p = 0.00001), had preoperative neurologic symptoms (21.2% vs 5.9%, p = 0.002), and had peripheral vascular disease (PVD) (63.6% vs 16.9%, p = 0.00001). The sensitivity of PVD for SCD is 63.6% (n = 21/33) (specificity 83.1%, positive predictive value 25.9%,negative predictive value 96.1%). In patients undergoing CABG alone, those who had postoperative NE were older (69.6 +/- 6.7 years vs 62.5 /- 10.3 years, p = 0.036) and more likely to have PVD (50% vs 19.7%, p = 0.034), SCD (40% vs 4.9%, p = 0.001) and previous CEA (40% vs 2.7%, p = 0.0002). The incidence of postoperative NE in patients with SCD was 18.2% vs 1.7% in patients without SCD (p = 0.001). The sensitivityof SCD for NE was 40% (n = 4/10) (specificity 95.1%, positive predictive value 18.2%, negative predictive value 98.3%). Conclusions: PVD may be helpful to identify patients at high risk for severe carotid artery stenosis. Postoperative NE in patients with CABG are associated with increasing age, carotid artery stenosis greater than 80%, previous CEA, and PVD.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/08/20 alle ore 18:36:15