In patients undergoing cardiac surgery does asymptomatic significant carotid artery stenosis warrant carotid endarterectomy?

A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether asymptomatic significant carotid artery stenosis (ASCAS) warrants carotid endarterectomy (CEA) in patients undergoing cardiac surgery. 128 Papers were found using the reported search, of these 10 presented represent the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that low risk, younger patients with a significant asymptomatic carotid artery stenosis should be considered for carotid endarterectomy at some stage. There is, however, no strong evidence that this must be performed prior to, or during CABG.