Pre-operative carotid artery screening in patients undergoing coronary artery bypass grafting

Results A total of 506 patients underwent CABG during the study period and 492 were included for analysis. 203 carotid artery Doppler ultrasound scans were performed. CAD screening was performed in 63/115 of the patients who met with class-I recommendations (history of stroke/transient ischaemic attack or carotid bruit) and 184/440 of the patients who met with class-IIa recommendations (age over 70 years and/or peripheral artery disease and/or multi-vessel coronary artery disease). There were 2 post-operative strokes, both in patients without CAD detected on pre-operative screening. Asynchronous carotid artery revascularisation was performed in 5 patients (4 prior to and 1 following CABG). Restricting carotid artery screening to class-I evidencebased recommendations criteria would have decrease the number of Doppler ultrasound scans from 203 to 115, without missing patients with CAD who actually required revascularisation.