Head and neck magnetic resonance angiography before coronary artery bypass grafting

Surg Today. 2005;35(6):432-5. doi: 10.1007/s00595-004-2973-4.

Abstract

Purpose: To evaluate the incidence of vascular lesions in the head and neck by magnetic resonance angiography (MRA), and investigate the factors correlated with severe stenosis.

Methods: Elective coronary artery bypass grafting (CABG) was performed in 413 patients at our center between May 1997 and April 2001. We used MRA to detect head and neck vascular lesions, then evaluated the occlusive lesions and determined their prevalence.

Results: Neck MRA was performed in 335 patients and head MRA was performed in 335 patients. We found > or = 60% stenosis or total occlusion of the extracranial carotid and vertebral artery in 43 patients (12.8%) and > or = 60% stenosis or occlusion of the intracranial carotid and basilar artery, or stenosis accompanied by poor peripheral perfusion or occlusion of the cerebral arteries in 45 patients (13.4%). Occlusive lesions of the neck were significantly correlated with mean age, peripheral vascular disease (PVD), and old myocardial infarction. Occlusive lesions of the brain were significantly correlated with age, hypertension, PVD, and left main trunk disease.

Conclusions: We found an equal incidence of intracranial and extracranial vascular lesions. Thus, searching for intracranial lesions is just as important as searching for extracranial lesions before CABG.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carotid Artery Diseases / diagnosis*
  • Carotid Artery Diseases / epidemiology
  • Comorbidity
  • Coronary Artery Bypass*
  • Female
  • Humans
  • Intracranial Arteriosclerosis / diagnosis*
  • Intracranial Arteriosclerosis / epidemiology
  • Magnetic Resonance Angiography*
  • Male
  • Middle Aged
  • Myocardial Ischemia / epidemiology
  • Myocardial Ischemia / surgery*
  • Tomography, Emission-Computed, Single-Photon