Assessment of carotid artery stenosis and lower limb peripheral ischemia before coronary artery bypass grafting operations: a non-randomized clinical trial

J Cardiothorac Surg. 2020 Sep 29;15(1):283. doi: 10.1186/s13019-020-01340-7.


Background: Atherosclerosis is a systemic disease affecting the coronary, carotid, and lower limb arteries. Cerebrovascular accidents and lower limb ischemia are devastating postoperative complications. We aimed to evaluate the role of non-selective routine arterial duplex scanning in patients undergoing coronary artery bypass grafting (CABG).

Methods: This non-randomized clinical trial included 360 patients scheduled for elective isolated CABG who were divided into two groups: low-risk (n = 180) and high-risk (n = 180). Both groups underwent preoperative carotid and lower limb ultrasound screening for associated arteriopathy.

Results: 16 (8.9%) patients and 22 (12.2%) patients showed ≥70% carotid artery stenosis while 11 patients (6.1%) and 20 patients (11.1%) showed ≥50% lower limb arterial stenosis in the low-risk group and the high-risk group, respectively; though the difference was not statistically significant in both the cases (p > 0.1).

Conclusion: Routine preoperative peripheral arterial screening by sonography is a feasible and effective strategy to avoid unnecessary post CABG complications.

Trial registration: NCT03516929 , Registered in 24 th of April 2018.

Keywords: CABG; Carotid; Coronary; Endarterectomy; Peripheral arterial disease.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Carotid Arteries / diagnostic imaging
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / surgery
  • Coronary Artery Bypass* / adverse effects
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / surgery*
  • Female
  • Humans
  • Ischemia / diagnostic imaging*
  • Lower Extremity / blood supply*
  • Lower Extremity / diagnostic imaging
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control
  • Risk Factors
  • Stroke / prevention & control
  • Time Factors
  • Treatment Outcome
  • Ultrasonography

Associated data