Waheed Khawaja B, Alzahrani Faisal M, Sharif Muhammad N, Al Jubair Nawaf N, Hundallah Mona J, Amin Muhammad S, Arulanantham Zechariah J
Department of Radiology, King Fahad Military Medical Complex, Dhahran, Kingdom of Saudi Arabia. E-mail:
Neurosciences (Riyadh). 2019 Apr;24(2):122-129. doi: 10.17712/nsj.2019.2.20180022.
To evaluate the use of duplex carotid artery screening in patients undergoing coronary artery bypass graft (CABG).
This descriptive, observational study was conducted in Radiology Department at King Fahad Military Medical Complex, Dhahran, Kingdom of Saudi Arabia from April 2015-2018. All Saudi patients (n=178) who underwent duplex carotid sonography prior to CABG were retrospectively reviewed for essential morphologic and hemodynamic information to estimate severity of extra-cranial internal carotid artery (ICA) stenosis. Patients with combined CABG and cardiac surgery, and those with limited carotid studies were excluded. Advancing age (65 years or above), gender, smoking, obesity, diabetes (DM), hypertension (HTN), dyslipidemia, coronary vessel disease, cardiac disease and previous stroke were recorded. Post-coronary artery bypass graft neurologic event (namely, transient ischemic attack [TIA] or stroke) was recorded. Chi-square test was used to determine association of stenosis degree with post-CABG neurologic event.
One hundred twenty eight patients (72%) were having ICA disease, while significant carotid artery stenosis (>70%) was seen in 11 patients (6.2%). Post-coronary artery bypass graft neurologic event was seen in 4.5% of patients. Advancing age, significant ICA stenosis and multi-vessel coronary disease were seen associated with a post-CABG event.
Significant ICA stenosis on duplex screening in elderly patients with multi-vessel coronary artery disease or certain risk factors may predict post-CABG stroke.
评估在接受冠状动脉旁路移植术（CABG）的患者中使用双功能颈动脉筛查的情况。
这项描述性观察性研究于2015年4月至2018年在沙特阿拉伯达兰法赫德国王军事医疗中心放射科进行。对所有在CABG术前接受双功能颈动脉超声检查的沙特患者（n = 178）进行回顾性分析，以获取重要的形态学和血流动力学信息，以评估颅外颈内动脉（ICA）狭窄的严重程度。排除接受CABG和心脏手术联合治疗的患者以及颈动脉研究受限的患者。记录年龄增长（65岁及以上）、性别、吸烟、肥胖、糖尿病（DM）、高血压（HTN）、血脂异常、冠状动脉疾病、心脏病和既往中风情况。记录冠状动脉旁路移植术后神经系统事件（即短暂性脑缺血发作[TIA]或中风）。采用卡方检验确定狭窄程度与CABG术后神经系统事件的相关性。
128例患者（72%）患有ICA疾病，11例患者（6.2%）出现显著的颈动脉狭窄（>70%）。4.5%的患者出现冠状动脉旁路移植术后神经系统事件。年龄增长、显著的ICA狭窄和多支冠状动脉疾病与CABG术后事件相关。
在患有多支冠状动脉疾病或某些危险因素的老年患者中，双功能筛查发现的显著ICA狭窄可能预示CABG术后中风。
