Azhar Mahmood Kayani, Ummarah Kamran, Nasir Khan, Anjum Jalal.
Frequency of carotid artery disease in candidates undergoing coronary artery bypass graft.
Pak Heart J Jan ;48(1):18-23.

Objective: To determine the frequency of carotid artery disease in patients undergoing coronary artery bypass graft (CABG) and to assess the association between carotid artery disease and coronary artery disease (CAD). Methodology: This cross sectional study was conducted at Rawalpindi Institut eof Cardiology, Rawalpindi, Pakistan from October 2013 to April 2014. All participants underwent pre-operative carotid Doppler assessment for level of stenosis and site of carotid plaque. Using the criteria defined by the Society of Radiologists in the Ultrasound Consensus, the degree of stenosis was stratified into the categories of normal (no stenosis), 50% non-obstructive carotid disease,50-69% significant stenosis, 70% critical stenosis to near occlusion, near occlusion, and total occlusion. Results: The total number of patients were 140 with the mean age of 59.6+-7.1 years. 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 plaque while the left internal carotid artery was the commonest site of both significant and critical stenosis. Near occlusion was noted in left ICA in two patients and right external carotid artery in one patient. Out of 128 patients who underwent CABG, 128 had TVD, DVD in 8 and 4 had SVD on coronary angiography. Conclusion: We concluded that high number of patients(77.85%) have carotid artery disease on routine ultrasonic carotid assessment. Carotid bulb was the most common site of plaque while the left internal carotid artery was the commonest site of both significant and critical stenosis.

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