Coronary artery bypass surgery perioperative carotid artery noninvasive screening: Difference between revisions
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[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]=== | ||
A multidisciplinary team approach (consisting of a cardiologist, cardiac surgeon, vascular surgeon, and neurologist) is recommended for patients with clinically significant carotid artery disease for whom CABG is planned. (Level of Evidence: C) | A multidisciplinary team approach (consisting of a cardiologist, cardiac surgeon, vascular surgeon, and neurologist) is recommended for patients with clinically significant carotid artery disease for whom CABG is planned. (Level of Evidence: C) | ||
[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]=== | ||
Carotid artery duplex scanning is reasonable in selected patients who are considered to have high-risk features (ie, age >65 years, left main coronary stenosis, PAD, history of cerebrovascular disease [transient ischemic attack [TIA], stroke, etc.], hypertension, smoking, and diabetes mellitus).858,859 (Level of Evidence: C) | Carotid artery duplex scanning is reasonable in selected patients who are considered to have high-risk features (ie, age >65 years, left main coronary stenosis, PAD, history of cerebrovascular disease [transient ischemic attack [TIA], stroke, etc.], hypertension, smoking, and diabetes mellitus).858,859 (Level of Evidence: C) | ||
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In the CABG patient with a previous TIA or stroke and a significant (50% to 99%) carotid artery stenosis, it is reasonable to consider carotid revascularization in conjunction with CABG. In such an individual, the sequence and timing (simultaneous or staged) of carotid intervention and CABG should be determined by the patient's relative magnitudes of cerebral and myocardial dysfunction. (Level of Evidence: C) | In the CABG patient with a previous TIA or stroke and a significant (50% to 99%) carotid artery stenosis, it is reasonable to consider carotid revascularization in conjunction with CABG. In such an individual, the sequence and timing (simultaneous or staged) of carotid intervention and CABG should be determined by the patient's relative magnitudes of cerebral and myocardial dysfunction. (Level of Evidence: C) | ||
[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ===[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]=== | ||
In the patient scheduled to undergo CABG who has no history of TIA or stroke, carotid revascularization may be considered in the presence of bilateral severe (70% to 99%) carotid stenoses or a unilateral severe carotid stenosis with a contralateral occlusion. (Level of Evidence: C)}} | In the patient scheduled to undergo CABG who has no history of TIA or stroke, carotid revascularization may be considered in the presence of bilateral severe (70% to 99%) carotid stenoses or a unilateral severe carotid stenosis with a contralateral occlusion. (Level of Evidence: C)}} |
Revision as of 14:15, 2 October 2012
Coronary Artery Bypass Surgery Microchapters | |
Pathophysiology | |
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Diagnosis | |
Treatment | |
Perioperative Monitoring | |
Surgical Procedure | |
Special Scenarios | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S. [2]
ACCF/AHA Guidelines for Perioperative Carotid Artery Noninvasive Screening
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Class IA multidisciplinary team approach (consisting of a cardiologist, cardiac surgeon, vascular surgeon, and neurologist) is recommended for patients with clinically significant carotid artery disease for whom CABG is planned. (Level of Evidence: C) Class IIaCarotid artery duplex scanning is reasonable in selected patients who are considered to have high-risk features (ie, age >65 years, left main coronary stenosis, PAD, history of cerebrovascular disease [transient ischemic attack [TIA], stroke, etc.], hypertension, smoking, and diabetes mellitus).858,859 (Level of Evidence: C) In the CABG patient with a previous TIA or stroke and a significant (50% to 99%) carotid artery stenosis, it is reasonable to consider carotid revascularization in conjunction with CABG. In such an individual, the sequence and timing (simultaneous or staged) of carotid intervention and CABG should be determined by the patient's relative magnitudes of cerebral and myocardial dysfunction. (Level of Evidence: C) Class IIbIn the patient scheduled to undergo CABG who has no history of TIA or stroke, carotid revascularization may be considered in the presence of bilateral severe (70% to 99%) carotid stenoses or a unilateral severe carotid stenosis with a contralateral occlusion. (Level of Evidence: C) |
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