Evidence map›Paper›PMID 42471735›Full record

SynthesisJournal of cardiothoracic surgery2026

Selective and non-selective carotid ultrasound screening and perioperative stroke incidence in the coronary artery bypass grafting population: a systematic review and meta-analysis.

Ben King-O'Reilly, Daniel Lewis Graves, Kabeshan Sandrasekaran, Norman Briffa

Abstract readSystematic ReviewMeta-AnalysisReview
In one paragraph

Synthesis in Journal of cardiothoracic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Ben King-O'ReillyCardiothoracic Department, The University of Sheffield Medical School, Sheffield, England. bmjking-oreilly1@sheffield.ac.uk.ORCID http://orcid.org/0009-0009-7061-3586
Daniel Lewis GravesCardiothoracic Department, The University of Sheffield Medical School, Sheffield, England.ORCID http://orcid.org/0009-0001-0722-3667
Kabeshan SandrasekaranCardiothoracic Department, The University of Sheffield Medical School, Sheffield, England.ORCID http://orcid.org/0009-0009-3970-4922
Norman BriffaCardiothoracic Department, The University of Sheffield Medical School, Sheffield, England.ORCID http://orcid.org/0000-0002-9060-6131

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesA systematic review and meta-analysis was performed to observe the incidence of perioperative stroke associated with selective and non-selective carotid ultrasound (CU) screening in the isolated coronary artery bypass grafting (CABG) population.

methodsPubMed, Scopus and CENTRAL databases were searched for studies published between January 1995 and October 2025. Inclusion criteria for the review focused on studies reporting primary data related to perioperative stroke in adult patients scheduled to undergo non-emergency isolated CABG who underwent either selective or non-selective preoperative CU screening. The primary outcome was perioperative stroke. Study quality was assessed using the ROBINS-I tool. Data related to the primary outcome was synthesised using an exploratory random-effects model meta-analysis. This review was reported as per PRISMA guidelines.

results2398 studies were identified to undergo title and abstract screening; 63 studies were identified to undergo full-text screening of which 15 studies were eligible for inclusion within the review (Total N = 25,931). For the 13 studies utilising a non-selective screening strategy, the pooled perioperative stroke rate was 1.78% (95% CI: [1.28;2.48]). Independently, the two cohorts utilising a selective screening strategy reported perioperative stroke rates of 1.16% and 1.23%. Due to the structural limitations of the existing literature these findings are presented as independent descriptive cohorts.

conclusionsThis review provides a descriptive synthesis of perioperative stroke rates across the two previously mentioned screening cohorts and does not establish comparative effectiveness. Although the low absolute event rates observed within the selective screening cohort align with current guideline recommendations, the structural limitations and high disproportion of the available evidence base prevent definitive comparison.

Indexed as

Carotid ArteriesCoronary Artery BypassPostoperative ComplicationsStrokeUltrasonography, Carotid ArteriesHumansIncidenceCarotid StenosisCarotid ultrasoundCoronary artery bypass graftingMeta-analysisPerioperative strokeScreening

Identifiers

PMID42471735
PMCPMC13662987

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.