The Preoperative Cerebrovascular Consultation: Common Cerebrovascular Questions before General or Cardiac Surgery

David J. Blacker, Kelly Flemming, Michael J. Link, Robert D Jr. Brown

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

All types of health care providers may be called on to evaluate the risk of ischemic stroke related to an upcoming surgical procedure, particularly in patients with established cerebrovascular disease. We outline possible mechanisms contributing to perioperative stroke, summarize available data on the stroke risk associated with selected surgeries, and highlight recognized risk factors. We then provide recommended answers to some of the questions commonly encountered at the preoperative cerebrovascular consultation: What is the appropriate time interval between a stroke and elective surgery? What is the perioperative stroke risk for patients with established carotid or vertebrobasilar large artery stenosis, and what are the cardiac implications of detecting a cerebrovascular large artery stenosis? Should patients with a large artery stenosis undergo prophylactic revascularization procedures before undergoing general surgery? What treatment is appropriate for patients with both coronary artery and carotid or vertebrobasilar large artery stenosis? What is the appropriate perioperative management of antiplatelet and anticoagulant medications with respect to stroke risk?

Original languageEnglish (US)
Pages (from-to)223-229
Number of pages7
JournalMayo Clinic Proceedings
Volume79
Issue number2
StatePublished - 2004

Fingerprint

Thoracic Surgery
Referral and Consultation
Stroke
Pathologic Constriction
Arteries
Cerebrovascular Disorders
Health Personnel
Anticoagulants
Coronary Vessels

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Preoperative Cerebrovascular Consultation : Common Cerebrovascular Questions before General or Cardiac Surgery. / Blacker, David J.; Flemming, Kelly; Link, Michael J.; Brown, Robert D Jr.

In: Mayo Clinic Proceedings, Vol. 79, No. 2, 2004, p. 223-229.

Research output: Contribution to journalArticle

@article{67357b882986499591ddbee483ae8446,
title = "The Preoperative Cerebrovascular Consultation: Common Cerebrovascular Questions before General or Cardiac Surgery",
abstract = "All types of health care providers may be called on to evaluate the risk of ischemic stroke related to an upcoming surgical procedure, particularly in patients with established cerebrovascular disease. We outline possible mechanisms contributing to perioperative stroke, summarize available data on the stroke risk associated with selected surgeries, and highlight recognized risk factors. We then provide recommended answers to some of the questions commonly encountered at the preoperative cerebrovascular consultation: What is the appropriate time interval between a stroke and elective surgery? What is the perioperative stroke risk for patients with established carotid or vertebrobasilar large artery stenosis, and what are the cardiac implications of detecting a cerebrovascular large artery stenosis? Should patients with a large artery stenosis undergo prophylactic revascularization procedures before undergoing general surgery? What treatment is appropriate for patients with both coronary artery and carotid or vertebrobasilar large artery stenosis? What is the appropriate perioperative management of antiplatelet and anticoagulant medications with respect to stroke risk?",
author = "Blacker, {David J.} and Kelly Flemming and Link, {Michael J.} and Brown, {Robert D Jr.}",
year = "2004",
language = "English (US)",
volume = "79",
pages = "223--229",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "2",

}

TY - JOUR

T1 - The Preoperative Cerebrovascular Consultation

T2 - Common Cerebrovascular Questions before General or Cardiac Surgery

AU - Blacker, David J.

AU - Flemming, Kelly

AU - Link, Michael J.

AU - Brown, Robert D Jr.

PY - 2004

Y1 - 2004

N2 - All types of health care providers may be called on to evaluate the risk of ischemic stroke related to an upcoming surgical procedure, particularly in patients with established cerebrovascular disease. We outline possible mechanisms contributing to perioperative stroke, summarize available data on the stroke risk associated with selected surgeries, and highlight recognized risk factors. We then provide recommended answers to some of the questions commonly encountered at the preoperative cerebrovascular consultation: What is the appropriate time interval between a stroke and elective surgery? What is the perioperative stroke risk for patients with established carotid or vertebrobasilar large artery stenosis, and what are the cardiac implications of detecting a cerebrovascular large artery stenosis? Should patients with a large artery stenosis undergo prophylactic revascularization procedures before undergoing general surgery? What treatment is appropriate for patients with both coronary artery and carotid or vertebrobasilar large artery stenosis? What is the appropriate perioperative management of antiplatelet and anticoagulant medications with respect to stroke risk?

AB - All types of health care providers may be called on to evaluate the risk of ischemic stroke related to an upcoming surgical procedure, particularly in patients with established cerebrovascular disease. We outline possible mechanisms contributing to perioperative stroke, summarize available data on the stroke risk associated with selected surgeries, and highlight recognized risk factors. We then provide recommended answers to some of the questions commonly encountered at the preoperative cerebrovascular consultation: What is the appropriate time interval between a stroke and elective surgery? What is the perioperative stroke risk for patients with established carotid or vertebrobasilar large artery stenosis, and what are the cardiac implications of detecting a cerebrovascular large artery stenosis? Should patients with a large artery stenosis undergo prophylactic revascularization procedures before undergoing general surgery? What treatment is appropriate for patients with both coronary artery and carotid or vertebrobasilar large artery stenosis? What is the appropriate perioperative management of antiplatelet and anticoagulant medications with respect to stroke risk?

UR - http://www.scopus.com/inward/record.url?scp=0942276274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0942276274&partnerID=8YFLogxK

M3 - Article

C2 - 14959917

AN - SCOPUS:0942276274

VL - 79

SP - 223

EP - 229

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 2

ER -