Carotid artery stenosis (CAS) and vertebral artery stenosis (VAS) are associated with cerebral infarction after cardiopulmonary bypass (CPB). We read with great interest the article “Cerebral Lesions in Patients Undergoing Coronary Artery Bypass Grafting in Relation to Asymptomatic Carotid and Vertebral Artery Stenosis”, by Wiberg et al.[1] The authors present a study that included patients treated for CABG procedures, in which CAS and VAS were identified by magnetic resonance angiography. Cerebral magnetic resonance imaging was performed to identify new post-operative subclinical cerebral lesions. Associations between CAS/VAS postoperative cerebral lesions were investigated. Forty-six patients were included in the study. Thirteen percent had significant CAS and 11% had significant VAS. Thirty-five percent had new cerebral infarction postoperatively. The authors found a significant association between the presence of cerebral vessel stenosis and acute cerebral infarction. In this letter to the editor, we emphasize that intraoperative management and monitoring during CPB could be crucial, in particular for patients with CAS and VAS who need urgent cardiac surgery.