冠状动脉旁路移植术后卒中及其与颈-颅动脉病变相关性的研究进展  

Progress in stroke after coronary artery bypass grafting and its association with carotidcerebral artery disease

作　　者：刘懿 朱云鹏[1] 赵强[1] LIU Yi;ZHU Yunpeng;ZHAO Qiang(Department of Cardiovascular Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,P.R.China)

机构地区：[1]上海交通大学医学院附属瑞金医院心血管外科,上海200025

出　　处：《中国胸心血管外科临床杂志》2024年第10期1538-1546,共9页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：上海市科学技术委员会生物医药重点项目(21Y21901300)。

摘　　要：冠状动脉旁路移植术(coronary artery bypass grafting,CABG)是左主干及复杂多支冠状动脉病变血运重建治疗的“金标准”。CABG术后卒中是一种相对少见但具有灾难性后果的并发症,并造成严重的卫生经济负担。近年来,对“泛血管疾病”这一概念的深入理解、“心脑一体化”诊疗理念的推行以及相关诊疗技术的提高,为该并发症的防治提供了新的选择。本文聚焦于颈-颅动脉病变这一关键因素,系统回顾了CABG术后卒中的发病率、流行病学现状、危险因素、发生机制及防治要点,分析了术后卒中与颈-颅动脉病变的关联,总结了预防性颈-颅动脉血运重建策略的循证依据,并对未来的研究方向做出展望。Coronary artery bypass grafting(CABG)is the"gold standard"for revascularization of left main diseased and/or complex multi-vessel diseased coronary artery disease.Post-CABG stroke is a relatively rare but catastrophic complication with a serious health and economic burden.In recent years,the further understanding of the concept of"panvascular disease",the implementation of the philosophy of"cardio-cerebral integrated treatment",and the improvement of related diagnostic and therapeutic techniques have provided new options for the recognition,prevention and cure of post-CABG stroke.Focusing on the key factor of carotid-cerebral artery disease,this review systematically scrutinizes the incidence,epidemiology,risk factors,mechanisms and prevention and treatment of post-CABG stroke.This review analyzes the association between post-CABG stroke and carotid-cerebral artery disease,summarizes the status of evidence-based prophylactic carotid-cerebral artery revascularization strategy,and prospects for future research directions.

关 键 词：冠状动脉旁路移植术 脑卒中 颈动脉病变 颅内动脉病变 颈动脉血运重建 综述 

分 类 号：R654.2[医药卫生—外科学]