MR angiographic evaluation of carotid and intracranial arteries in Japanese patients scheduled for coronary artery bypass grafting

Background and Purpose: Stroke is a serious complication of coronary artery bypass grafting (CABG). Preoperative evaluation of the cerebral arteries t o identify patients at increased risk of stroke after CABG is important. In a prospective study, we evaluated cerebral artery occlusive lesions with M R angiography in Japanese patients scheduled to undergo CABG to determine t he prevalence of occlusive diseases in the extracranial carotid anti intrac ranial arteries in this population and to identify preoperative risk factor s for these patients. Method: The subjects were 151 consecutive patients (1 15 men and 36 women ranging in age from 41 to 82 years) who were scheduled for CABG under non-emergency conditions between October 1995 and February 1 998. Carotid and intracranial arteries were examined for occlusive lesions with MR angiography. Patient demographics and risk factors including age, s ex, hypertension, diabetes mellitus, hyperlipidemia, smoking habit, history of stroke, peripheral vascular disease and preoperative thromboembolic inf arcts revealed by MR imaging were recorded and analyzed. Results: Cervical carotid artery stenoses of more than 50% narrowing were detected in 16.6% o f the subjects, and intracranial artery stenoses of more than 50% narrowing were detected in 21.2% of the subjects. Multiple logistic regression analy ses identified peripheral vascular disease and lacunar infarcts in the basa l ganglia as significant and independent predictors of cervical carotid art erial stenoses. No significant predictor for intracranial arterial stenoses was identified. Conclusions: The prevalence of extracranial carotid and in tracranial artery stenosis in Japanese patients scheduled for CABG is consi derably high. MR angiography is of value of identifying these patients. Pre operative evaluation of cranial arteries is recommended, particularly in pa tients with peripheral vascular disease and infarcts in the basal ganglia. Copyright (C) 2001 S. Karger AG, Basel.