Duplex carotid sonography was performed on 80 patients undergoing abdominal or peripheral vascular surgery for atherosclerotic disease. High-grade stenosis (over 50%) of one or both common or internal carotid arteries was present in 17 patients. In three of these patients ischemic cerebral infarcts developed in the territory of the most severely stenosed artery within 1 to 40 days after surgery. The other patients had no postoperative central nervous system complications. Duplex carotid sonography is indicated in patients prior to vascular surgery in order to identify the group at risk for the development of cerebrovascular accidents. Carotid endarterectomy prior to or at the time of surgery may prevent this complication.
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