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More Study Is Needed

Magdy Selim, MD, PhD

Arch Neurol. 2008;65(12):1672-1674.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The presence of carotid occlusive disease (COD) in patients undergoing coronary artery bypass grafting (CABG) often raises concern about the risk of perioperative stroke. Although the role of COD as a risk factor for stroke is unquestioned, the role of COD alone, especially when asymptomatic, in predisposing patients to peri-CABG stroke is less certain, and the effectiveness of means to diminish it is controversial. Results from the Asymptomatic Carotid Atherosclerosis Study and Asymptomatic Carotid Surgery Trial prompted some physicians to advocate carotid endarterectomy (CEA) for asymptomatic COD in patients undergoing CABG for stroke prevention.^1-2 Other physicians recommend medical treatment, citing concerns about the morbidity of CEA in this high-risk patient population, stating that the risk to benefit ratio does not warrant routine pre-CABG prophylactic CEA.

The Food and Drug Administration's approval of carotid angioplasty and stenting for the treatment of COD, the relative ease of performing . . . [Full Text of this Article]

PERIOPERATIVE STROKE RISK IN PATIENTS WITH COD


MECHANISMS OF PERIOPERATIVE STROKE IN PATIENTS WITH COD

RISK VS BENEFIT OF PROPHYLACTIC ANGIOPLASTY AND STENTING

AUTHOR INFORMATION
Author Affiliations: Department of Neurology,Division of Cerebrovascular Diseases, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

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