Stroke is a devastating complication following coronary artery bypass
grafting, which thankfully occurs with low incidence. The role of
preoperative carotid ultrasound remains unclear. Whilst it is a cheap
and reliable way of diagnosing carotid stenosis, it is unclear if and
how this knowledge should impact on subsequent patient management. The
evidence overall suggests that patients with severe carotid stenosis are
likely to have an increased incidence of postoperative stroke --
however, the prevalence of severe carotid stenosis is low, and even in
this cohort of patients, the incidence is not particularly high. In
screened patients identified to have severe carotid stenosis, there
appears to be a generally low appetite for undertaking carotid
intervention internationally either prior to or concurrently with the
coronary artery bypass grafting. Putting this all together, the
widespread screening of asymptomatic patients would appear to not be
justified.