Carotid Bruit and the Risk of Stroke in Elective Surgery

Abstract

The finding of a carotid-artery bruit before elective surgery leads to a variety of actions among different physicians. Some recommend angiography or noninvasive carotid-artery studies followed by endarterectomy if appropriate,^{1 , 2} others recommend study only in candidates for cardiac bypass surgery^{3 4 5} or operations anticipated to involve large blood losses, and many consider the bruit to be an unimportant risk factor for perioperative or intraoperative stroke.^{6 7 8 9 10} However, studies failing to demonstrate a risk of stroke in association with a carotid bruit have been retrospective, with an uncertain true incidence of bruit and stroke,^{6 7 8} and sample sizes in prospective studies^{9 , 10} have not been . . .