Management Of Asymptomatic Carotid Artery Disease In Patients Undergoing CABG In A Tertiary Care Centre In Eastern India: A Retrospective Observational Study

Abstract

Background and aim: Atherosclerosis is a systemic disease that typically affects multiple arterial beds of the same patient. The incidence of coexisting coronary and carotid artery disease varies between 2% and 14%, and 8% of patients undergoing coronary artery bypass grafting (CABG) have a significant stenosis in an extracranial carotid artery. In this study, we tried to compile current evidence to prepare some strategies for the best management of coexisting severe carotid disease in patients admitted for CABG. We also aim to reduce the risk of neurological complications following CABG.Material and methods: Our study was a retrospective observational study. The results were prepared by statistical analysis of our collected demographic data. In the study, we observed 30 patients admitted to the CTVS department of IPGMER and SSKM Hospital who underwent CABG over a 1.5-year period.Results: Individuals who had received preoperative treatment for coexisting extracranial carotid artery disease before CABG have a decreased occurrence of postoperative focal neurological deficits and a reduced history of postoperative CVA.Conclusions: Patients with high-grade carotid stenosis who have undergone cardiac surgery are at increased risk for perioperative stroke. Carotid stenosis should only be surgically treated before coronary surgery in people who are at high risk for a stroke during surgery. In these patients, the risk of a cerebral embolism is likely to be mostly due to carotid atherosclerosis. A staged surgical approach is recommended. Stenting of carotid arteries represents a less invasive alternative for high-risk surgical patients.

Keywords

• atherosclerosis
• coronary artery bypass
• coronary artery disease