FREQUENCY OF CAROTID ARTERY DISEASE IN CANDIDATES UNDERGOING CORONARY ARTERY BYPASS GRAFT

Abstract

Objective: To determine the frequency of carotid artery disease in patients undergoing coronary artery bypass graft (CABG) and to assess the associationbetween carotid artery disease and coronary artery disease (CAD).

Methodology: This cross sectional study was conducted at Rawalpindi Instituteof Cardiology, Rawalpindi, Pakistan from October 2013 to April 2014. Allparticipants underwent pre-operative carotid Doppler assessment for level ofstenosis and site of carotid plaque. Using the criteria defined by the Society ofRadiologists in the Ultrasound Consensus, the degree of stenosis was stratifiedinto the categories of normal (no stenosis), 50% non-obstructive carotid disease,50-69% significant stenosis, 70% critical stenosis to near occlusion, nearocclusion, and total occlusion.

Results: The total number of patients were 140 with the mean age of 59.6±7.1years. Male to female ratio was 4:1. Normal carotid arteries were seen in 31(22.2%) patients, while 79 (56.4%) had non-obstructive carotid disease, 15(10.7%) had significant stenosis, 12 (8.5%) had critical stenosis, and 3 (2.1%)had near occlusion stenosis. Carotid bulb was the most common site of plaquewhile the left internal carotid artery was the commonest site of both significantand critical stenosis. Near occlusion was noted in left ICA in two patients and rightexternal carotid artery in one patient. Out of 128 patients who underwentCABG,128 had TVD, DVD in 8 and 4 had SVD on coronary angiography..

Conclusion: We concluded that high number of patients(77.85%) have carotidartery disease on routine ultrasonic carotid assessment. Carotid bulb was themost common site of plaque while the left internal carotid artery was thecommonest site of both significant and critical stenosis.