Carotid Bruit and the Risk of Stroke in Elective Surgery

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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 surgery3 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 studies9 , 10 have not been . . .