Progress in stroke after coronary artery bypass grafting and its association with carotid-cerebral artery disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Yi , ZHU Yunpeng ,  ZHAO Qiang

Department of Cardiovascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, P. R. China;

Corresponding author：

ZHAO Qiang, Email: zq11607@rjh.com.cn

Keywords：

Coronary artery bypass grafting; stroke; carotid artery disease; intracranial artery disease; carotid artery revascularization; review

DOI：

10.7507/1007-4848.202212020

Video：

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Abstract Full text Figures/Tables Video References Cited by

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.

Citation： LIU Yi, ZHU Yunpeng, ZHAO Qiang. Progress in stroke after coronary artery bypass grafting and its association with carotid-cerebral artery disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(10): 1538-1546. doi: 10.7507/1007-4848.202212020 Copy

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2. Lawton JS, Tamis-Holland JE, et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2022, 79(2): e21-e129.
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6. Naylor AR, Mehta Z, Rothwell PM, et al. Carotid artery disease and stroke during coronary artery bypass: A critical review of the literature. Eur J Vasc Endovasc Surg, 2002, 23(4): 283-294.
7. Naylor AR, Bown MJ. Stroke after cardiac surgery and its association with asymptomatic carotid disease: An updated systematic review and meta-analysis. Eur J Vasc Endovasc Surg, 2011, 41(5): 607-624.
8. Li Y, Walicki D, Mathiesen C, et al. Strokes after cardiac surgery and relationship to carotid stenosis. Arch Neurol, 2009, 66(9): 1091-1096.
9. Xiang B, Luo X, Yang Y, et al. Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization. J Vasc Surg, 2019, 70(6): 1942-1949.
10. Feldman DN, Swaminathan RV, Geleris JD, et al. Comparison of trends and in-hospital outcomes of concurrent carotid artery revascularization and coronary artery bypass graft surgery: The United States experience 2004 to 2012. JACC Cardiovasc Interv, 2017, 10(3): 286-298.
11. Knipp SC, Holst T, Bilbilis K, et al. Five-year results of coronary artery bypass grafting with or without carotid endarterectomy in patients with asymptomatic carotid artery stenosis: CABACS RCT. Stroke, 2022, 53(11): 3270-3277.
12. Tzoumas A, Giannopoulos S, Texakalidis P, et al. Synchronous versus staged carotid endarterectomy and coronary artery bypass graft for patients with concomitant severe coronary and carotid artery stenosis: A systematic review and meta-analysis. Ann Vasc Surg, 2020, 63: 427-438.
13. Giannopoulos S, Texakalidis P, Charisis N, et al. Synchronous carotid endarterectomy and coronary artery bypass graft versus staged carotid artery stenting and coronary artery bypass graft for patients with concomitant severe coronary and carotid stenosis: A systematic review and meta-analysis. Ann Vasc Surg, 2020, 62: 463-473.
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16. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med, 2009, 360(10): 961-972.
17. Roy P, Brahme I, Reddy RP, et al. Meta-analysis of perioperative stroke and mortality in CABG patients with carotid stenosis. Neurologist, 2020, 25(5): 113-116.
18. Tarakji KG, Sabik JF, Bhudia SK, et al. Temporal onset, risk factors, and outcomes associated with stroke after coronary artery bypass grafting. JAMA, 2011, 305(4): 381-390.
19. Fernandez FG, Shahian DM, Kormos R, et al. The Society of Thoracic Surgeons National Database 2019 annual report. Ann Thorac Surg, 2019, 108(6): 1625-1632.
20. Lorusso R, Moscarelli M, Di Franco A, et al. Association between coronary artery bypass surgical techniques and postoperative stroke. J Am Heart Assoc, 2019, 8(24): e013650.
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22. Mérie C, Køber L, Olsen PS, et al. Risk of stroke after coronary artery bypass grafting: Effect of age and comorbidities. Stroke, 2012, 43(1): 38-43.
23. Edwards FH, Ferraris VA, Kurlansky PA, et al. Failure to rescue rates after coronary artery bypass grafting: An analysis from the Society of Thoracic Surgeons Adult Cardiac Surgery Database. Ann Thorac Surg, 2016, 102(2): 458-464.
24. O'Brien SM, Feng L, He X, et al. The Society of Thoracic Surgeons 2018 adult cardiac surgery risk models: Part 2: Statistical methods and results. Ann Thorac Surg, 2018, 105(5): 1419-1428.
25. ElBardissi AW, Aranki SF, Sheng S, et al. Trends in isolated coronary artery bypass grafting: An analysis of the Society of Thoracic Surgeons adult cardiac surgery database. J Thorac Cardiovasc Surg, 2012, 143(2): 273-281.
26. Messé SR, Acker MA, Kasner SE, et al. Stroke after aortic valve surgery: Results from a prospective cohort. Circulation, 2014, 129(22): 2253-2261.
27. Knipp SC, Matatko N, Wilhelm H, et al. Evaluation of brain injury after coronary artery bypass grafting. A prospective study using neuropsychological assessment and diffusion-weighted magnetic resonance imaging. Eur J Cardiothorac Surg, 2004, 25(5): 791-800.
28. Gaudino M, Angiolillo DJ, Di Franco A, et al. Stroke after coronary artery bypass grafting and percutaneous coronary intervention: Incidence, pathogenesis, and outcomes. J Am Heart Assoc, 2019, 8(13): e013032.
29. Filsoufi F, Rahmanian PB, Castillo JG, et al. Incidence, topography, predictors and long-term survival after stroke in patients undergoing coronary artery bypass grafting. Ann Thorac Surg, 2008, 85(3): 862-870.
30. Likosky DS, Marrin CA, Caplan LR, et al. Determination of etiologic mechanisms of strokes secondary to coronary artery bypass graft surgery. Stroke, 2003, 34(12): 2830-2834.
31. Lee EJ, Choi KH, Ryu JS, et al. Stroke risk after coronary artery bypass graft surgery and extent of cerebral artery atherosclerosis. J Am Coll Cardiol, 2011, 57(18): 1811-1818.
32. Bottle A, Mozid A, Grocott HP, et al. Preoperative stroke and outcomes after coronary artery bypass graft surgery. Anesthesiology, 2013, 118(4): 885-893.
33. Selnes OA, Gottesman RF, Grega MA, et al. Cognitive and neurologic outcomes after coronary-artery bypass surgery. N Engl J Med, 2012, 366(3): 250-257.
34. Stamou SC, Hill PC, Dangas G, et al. Stroke after coronary artery bypass: Incidence, predictors, and clinical outcome. Stroke, 2001, 32(7): 1508-1513.
35. Roach GW, Kanchuger M, Mangano CM, et al. Adverse cerebral outcomes after coronary bypass surgery. Multicenter study of Perioperative Ischemia Research Group and the Ischemia Research and Education Foundation Investigators. N Engl J Med, 1996, 335(25): 1857-1863.
36. Benedetto U, Gaudino MF, Dimagli A, et al. Postoperative atrial fibrillation and long-term risk of stroke after isolated coronary artery bypass graft surgery. Circulation, 2020, 142(14): 1320-1329.
37. Gottesman RF, Sherman PM, Grega MA, et al. Watershed strokes after cardiac surgery: Diagnosis, etiology, and outcome. Stroke, 2006, 37(9): 2306-2311.
38. Kotoh K, Fukahara K, Doi T, et al. Predictors of early postoperative cerebral infarction after isolated off-pump coronary artery bypass grafting. Ann Thorac Surg, 2007, 83(5): 1679-1683.
39. Amar D, Shi W, Hogue CW, et al. Clinical prediction rule for atrial fibrillation after coronary artery bypass grafting. J Am Coll Cardiol, 2004, 44(6): 1248-1253.
40. Likosky DS, Leavitt BJ, Marrin CA, et al. Intra- and postoperative predictors of stroke after coronary artery bypass grafting. Ann Thorac Surg, 2003, 76(2): 428-434.
41. Kosmidou I, Chen S, Kappetein AP, et al. New-onset atrial fibrillation after PCI or CABG for left main disease: The EXCEL trial. J Am Coll Cardiol, 2018, 71(7): 739-748.
42. Yang WJ, Wong KS, Chen XY. Intracranial atherosclerosis: From microscopy to high-resolution magnetic resonance imaging. J Stroke, 2017, 19(3): 249-260.
43. 郑哲, 顾大川, 陈斯鹏. 中国冠状动脉旁路移植术医疗质量控制工作报告. 中国循环杂志, 2020, 35(8): 729-738.Zheng Z, Gu DC, Chen SP. Healthcare quality and performance improvement for coronary artery bypass grafting in China. Chin Circ J, 2020, 35(8): 729-738.
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