Clinical prognosis of staged coronary artery bypass grafting and carotid stent implantation in patients with preoperative stroke
- VernacularTitle:分期行冠状动脉旁路移植术和颈动脉支架植入术对术前脑卒中患者的临床预后研究
- Author:
Qi XIA
1
;
Chentao LUO
1
;
Yi LIN
1
;
Yunqing SHI
1
;
Runhua MA
1
;
Wenjun DING
1
Author Information
1. Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, 200032, P. R. China
- Publication Type:Journal Article
- Keywords:
Stage;
carotid artery stenting;
coronary artery bypass grafting;
coronary heart disease;
carotid artery stenosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(05):565-571
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the short-term and long-term efficacy of staged coronary artery bypass grafting (CABG) and carotid artery stenting (CAS) compared with CABG alone in patients with coronary heart disease with preoperative history of stroke and carotid stenosis. Methods We reviewed the clinical data of 55 patients (48 males, 7 females, aged 67.62±7.06 years) with coronary heart disease and carotid stenosis who had a history of stroke and underwent CABG+CAS or CABG alone in Zhongshan Hospital from 2008 to 2017. There were 13 patients in the staged CABG+CAS group and 42 patients in the CABG alone group. The differences in the incidence of perioperative adverse events and long-term survival between the two groups were studied, and univariate and multivariate analyses were carried out to determine the independent risk factors of long-term adverse events. Results Perioperative adverse events occurred in 1 (7.69%) patient of the staged CABG+CAS group, and 4 (9.52%) patients of the CABG alone group (P=0.84). During the follow-up period (67.84±37.99 months), the long-term survival rate of patients in the staged CABG+CAS group was significantly higher than that in the CABG alone group (P=0.02). The risk of long-term adverse events in the staged CABG+CAS group was 0.22 times higher than that in the CABG alone group (95%CI 0.05-0.92, P=0.04). Conclusion Staged CABG+CAS can significantly improve the long-term survival prognosis without increasing the perioperative risk. It is a safe and effective treatment, but prospective randomized studies are still needed to further confirm this finding.
