LAUSR

W hether undergoing cardiac surgery or interventional cardiology procedures, patients and physicians often consider stroke as the most devastating potential complication—for some, even more so than death. In the case of coronary revascularization, coronary artery bypass grafting (CABG) may result in cerebral infarction as a result of atheroembolism due to aortic crossclamping, insertion of (and perfusion through) arterial cannulae, aortic manipulation for proximal anatamoses, and “watershed” infarcts due to hypoperfusion. Similarly, stroke during percutaneous coronary intervention (PCI) is precipitated by the manipulation of wires and catheters through the aorta via either the iliofemoral or subclavian systems or sometimes due to elaboration of coronary or graft atheroma into the central circulation. Both procedures may cause hemorrhagic stroke due to the highdose antithrombotic and antiplatelet therapies (in the setting of PCI) that are required (1).