Carotid stenting in coronary artery bypass grafting patients with asymptomatic severe carotid artery stenosis
10.3760/cma.j.cn112434-20231013-00086
- VernacularTitle:颈动脉支架置入术在合并无症状颈动脉重度狭窄的冠状动脉旁路移植术中的应用
- Author:
Mingxiu WEN
1
;
Songhao JIA
;
Shipan WANG
;
Shuanglei ZHAO
;
Yang LIU
;
Yuanshu PENG
;
Dong XU
;
Pixiong SU
;
Ming GONG
Author Information
1. 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Keywords:
Asymptomatic carotid stenosis;
Carotid artery stenting;
Coronary artery bypass grafting
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(12):735-739
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the perioperative and follow-up data of carotid artery stenting (CAS)+ coronary artery bypass grafting (CABG) and CABG alone, and to assess the safety and efficacy of CAS in the treatment of severe stenosis of the carotid artery in combination with asymptomatic carotid artery stenosis.Methods:A retrospective analysis of 700 CABG patients combined asymptomatic carotid artery severe stenosis at Beijing Anzhen Hospital, Beijing Chaoyang Hospital, and Beijing Tiantan Hospital from January 2018 to December 2022 was performed. According to whether or not underwent CAS treatment, they were divided into the CAS-CABG group(116 cases)and the CABG-only group(584 cases). The mean age of the CAS-CABG group was (64.8±7.3) years, and all of them underwent unilateral CAS surgery only; the mean age of the CABG only group was (65.5±7.6) years. The main results of the patients in the two groups were compared at 30 days after the operation and follow-up period.Results:The early postoperative stroke rate was significantly lower in the CAS-CABG group(2.6% vs. 9.1%, P=0.02), while the combined procedure did not increase the rates of mortality and adverse events during follow-up. Subgroup analysis revealed that there was no significant difference in stroke rates between the two procedures for asymptomatic unilateral carotid artery stenosis, advanced age, history of atrial fibrillation, and history of stroke were independent risk factors for early stroke in CABG for asymptomatic unilateral carotid artery stenosis. Conclusion:CAS-CABG is safe and effective in the treatment of coronary artery disease combined with asymptomatic carotid artery stenosis, and can reduce the incidence of early postoperative stroke in patients. CABG patients with asymptomatic carotid stenosis should be rationally screened for prophylactic CAS to reduce the risk of postoperative stroke in these patients.
