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Stroke as a complication of carotid sinus massage

A 77-yr-old white man recovering from aortobiiliac bypass surgery suffered a sudden stroke within 30 min after carotid sinus massage was performed in an attempt to treat supraventricular tachycardia. Even though carotid digital subtraction angiography and angiograms were negative for carotid artery disease, we believe that there was enough plaque or vascular disease to precipitate the stroke. Considering the prevalence of atherosclerotic vascular disease in the general population, we recommend avoiding carotid sinus massage in elderly patients, even in the apparent absence of carotid artery disease.