Advanced Search

Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 1999 December;40(6) > The Journal of Cardiovascular Surgery 1999 December;40(6):829-36

ISSUES AND ARTICLES   MOST READ   eTOC

CURRENT ISSUETHE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Frequency: Bi-Monthly

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1999 December;40(6):829-36

VASCULAR PAPERS 

    ORIGINAL ARTICLES

The ­utility of selec­tive ­screening for ­carotid sten­osis in car­diac sur­gery ­patients

Hill A. B., Obrand D., Steinmetz O. K.

From the Divi­sion of Vas­cular Sur­gery, ­McGill Uni­ver­sity Mon­treal, ­Quebec, ­Canada

Pur­pose. To deter­mine if any of 8 cat­e­gor­ical clin­ical var­i­ables can be ­used to ­select ­patients and ­improve the ­yield of a ­screening pro­gram for ­severe ­carotid sten­osis (≥ 80%) in elec­tive car­diac sur­gery ­patients.
­Methods. A pros­pec­tive ­cohort anal­ysis of 200 con­sec­u­tive ­patients ­prior to elec­tive car­diac sur­gery for the fol­lowing var­i­ables: age, ­gender, ­smoking, ­carotid ­bruit, periph­eral vas­cular dis­ease, hyper­lip­i­daemia, pre­vious neu­ro­logic symp­toms and dia­betes mel­litus. All ­patients ­were sub­se­quently ­screened ­with ­carotid ­duplex scan­ning for the pres­ence of ­severe ­carotid sten­osis. Pos­i­tive ­scans ­were con­firmed by angio­graphy.
­Results. Six­teen ­patients (8%) ­were iden­ti­fied ­with ­severe ­carotid sten­osis. Uni­var­iate anal­ysis iden­ti­fied ­three var­i­ables ­that ­increase ­risk for ­carotid sten­osis: ­carotid ­bruit (rel­a­tive ­risk (RR)=16.4, 5.4-57.6 95% con­fi­dence ­interval, p<0.001), neu­ro­log­ical his­tory (RR=10.3, 3.9-23.2, p<0.001) and periph­eral vas­cular dis­ease (RR=5.3, 1.9-14.9, p<0.001). Step­wise ­logistic regres­sion anal­ysis iden­ti­fied pre­vious neu­ro­logic his­tory and ­carotid ­bruit as inde­pen­dent pre­dic­tors of sten­osis. If ­screening for ­carotid sten­osis was lim­ited to ­patients ­with ­these two var­i­ables, ­then 37 (18.5% of ­total) ­patients ­would ­have ­been ­screened. Four­teen of ­these 37 (37.8%) had a ­severe ­carotid sten­osis. Two ­patients ­with sten­osis (12.5% of ­those ­with ­carotid sten­osis, 1% of ­total ­patient pop­u­la­tion) ­would not ­have ­been ­screened.
Con­clu­sions. Clin­ical var­i­ables can be ­used to ­improve the ­yield of a pre­op­er­a­tive ­screening pro­gram for ­carotid sten­osis.

language: English


Full text temporarily not available online. Contact us  REPRINTS

top of page