- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, P. R. China;
Perioperative stroke is a severe complication with poor prognosis in patients undergoing surgical treatment for lung cancer. It not only significantly increases postoperative mortality risk but also frequently leads to permanent neurological deficits, severely impairing patients' quality of life and adversely affecting long-term outcomes. With the continuous increase in the volume of lung cancer surgeries and the aggravation of population aging, the prevention and management of perioperative stroke have become an urgent clinical challenge in the field of thoracic surgery. However, there is currently a lack of systematic and standardized guidance documents specifically addressing the prevention and management of perioperative stroke in lung cancer surgery in China. To address this gap, experts in relevant fields in China developed this consensus based on the latest evidence-based medical evidence, systematically searching authoritative domestic and international databases, including high-quality clinical studies, guidelines, and systematic review published in the past decade, and incorporating the clinical characteristics of Chinese patients undergoing lung cancer surgery. The Delphi method was adopted to finalize the recommendations. This consensus has formulated 18 recommendations based on research related to perioperative stroke in lung cancer surgery, aiming to provide clinicians with standardized prevention and management strategies, thereby reducing the incidence of perioperative stroke and improving the prognosis and quality of life of affected patients.
Copyright ? the editorial department of Chinese Journal of Clinical Thoracic and Cardiovascular Surgery of West China Medical Publisher. All rights reserved
| 1. | Nishizawa N, Okawara M, Mori M, et al. Postoperative cerebral infarction risk is related to lobectomy site in lung cancer: a retrospective cohort study of nationwide data in Japan[J/OL]. BMJ Open Respir Res, 2022, 9(1): e001327. DOI: 10.1136/bmjresp-2022-001327. |
| 2. | Zhou Y, Wang X, Yin W, et al. Perioperative stroke deteriorates white matter integrity by enhancing cytotoxic CD8+ T-cell activation[J/OL]. CNS Neurosci Ther, 2024, 30(7): e14747. DOI: 10.1111/cns.14747. |
| 3. | Bushnell C, Kernan WN, Sharrief AZ, et al. 2024 guideline for the primary prevention of stroke: a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2024, 55(12): e344-e424. DOI: 10.1161/str.0000000000000482. |
| 4. | Vlisides PE, Moore LE, Whalin MK, et al. Perioperative care of patients at high risk for stroke during or after non-cardiac, non-neurological surgery: 2020 guidelines from the Society for Neuroscience in Anesthesiology and Critical Care[J]. J Neurosurg Anesthesiol, 2020, 32(3): 210-226. |
| 5. | Quinlan M, Arora R, Cho SM. Postoperative Brain Attack: Current Perspectives and Future Directions[J]. Semin Thorac Cardiovasc Surg, 2025, 37(3): 281-292. |
| 6. | Al-Hader R, Al-Robaidi K, Jovin T, et al. The incidence of perioperative stroke: estimate using state and national databases and systematic review[J]. J Stroke, 2019, 21(3): 290-301. |
| 7. | Benesch C, Glance LG, Derdeyn CP, et al. Perioperative neurological evaluation and management to lower the risk of acute stroke in patients undergoing noncardiac, nonneurological surgery: a scientific statement from the American Heart Association/American Stroke Association[J/OL]. Circulation, 2021, 143(19): e923-e946. DOI: 10.1161/cir.0000000000000968. |
| 8. | Shu L, Aziz YN, de Havenon A, et al. Perioperative stroke: mechanisms, risk stratification, and management[J]. Stroke, 2025, 56(9): 2798-2809. |
| 9. | Marcucci M, Chan MTV, Smith EE, et al. Prevention of perioperative stroke in patients undergoing non-cardiac surgery[J]. Lancet Neurol, 2023, 22(10): 946-958. |
| 10. | Yoo J, Kwon I, Kim S, et al. Coagulation factor expression and composition of arterial thrombi in cancer-associated stroke[J]. Stroke, 2023, 54(12): 2981-2989. |
| 11. | Riddersholm S, Tayal B, Kragholm K, et al. Incidence of stroke after pneumonectomy and lobectomy[J]. Stroke, 2019, 50(5): 1052-1059. |
| 12. | Rousseau J, Wen PY. Cerebrovascular and peripheral vascular complications in cancer patients[J/OL]. Curr Neurol Neurosci Rep, 2025, 25(1): 46. DOI: 10.1007/s11910-025-01434-6. |
| 13. | Navi BB, Reiner AS, Kamel H, et al. Risk of arterial thromboembolism in patients with cancer[J]. J Am Coll Cardiol, 2017, 70(8): 926-938. |
| 14. | Khorvash F, Khalili M, Rezvani Habibabadi R, et al. Comparison of acute ischemic stroke evaluation and the etiologic subtypes between university and nonuniversity hospitals in Isfahan, Iran[J]. Int J Stroke, 2019, 14(6): 613-619. |
| 15. | Li L, Scott CA, Rothwell PM. Association of younger vs. older ages with changes in incidence of stroke and other vascular events, 2002-2018[J]. JAMA, 2022, 328(6): 563-574. |
| 16. | Devereaux PJ, Marcucci M. Perioperative covert stroke: acutely asymptomatic but not benign[J]. Anesthesiology, 2025, 142(3): 431-433. |
| 17. | Cui Q, Zhao W, Chen H, et al. Covert perioperative strokes in older patients having noncardiac surgery (PRECISION): a prospective cohort analysis[J]. Anesthesiology, 2025, 142(3): 443-453. |
| 18. | Fanning JP, Campbell BCV, Bulbulia R, et al. Perioperative stroke[J/OL]. Nat Rev Dis Primers, 2024, 10(1): 3. DOI: 10.1038/s41572-023-00487-6. |
| 19. | Kwon S, Lee SR, Choi EK, et al. Association between atrial fibrillation and diabetes-related complications: a nationwide cohort study[J]. Diabetes Care, 2023, 46(12): 2240-2248. |
| 20. | Chyou JY, Barkoudah E, Dukes JW, et al. Atrial fibrillation occurring during acute hospitalization: a scientific statement from the American Heart Association[J/OL]. Circulation, 2023, 147(15): e676-e698. DOI: 10.1161/cir.0000000000001147. |
| 21. | Goeller JK, Bartels K. Improving prediction to prevent perioperative morbidity[J]. Br J Anaesth, 2021, 127(5): 671-674. |
| 22. | Glance LG, Benesch CG, Holloway RG, et al. Association of time elapsed since ischemic stroke with risk of recurrent stroke in older patients undergoing elective nonneurologic, noncardiac surgery[J/OL]. JAMA Surg, 2022, 157(8): e222236. DOI: 10.1001/jamasurg.2022.2236. |
| 23. | Leung YYR, Bera K, Urriza Rodriguez D, et al. Safety of carotid endarterectomy for symptomatic stenosis by age: meta-analysis with individual patient data[J]. Stroke, 2023, 54(2): 457-467. |
| 24. | Kernan WN, Viera AJ, Billinger SA, et al. Primary care of adult patients after stroke: a scientific statement from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2021, 52(9): e558-e571. DOI: 10.1161/str.0000000000000382. |
| 25. | Seiffge DJ, Cancelloni V, R?ber L, et al. Secondary stroke prevention in people with atrial fibrillation: treatments and trials[J]. Lancet Neurol, 2024, 23(4): 404-417. |
| 26. | Nies KPH, Smits LJM, van Kuijk SMJ, et al. Individualized MRI-based stroke prediction score using plaque vulnerability for symptomatic carotid artery disease patients (IMPROVE)[J]. Stroke, 2025, 56(8): 2068-2078. |
| 27. | Rajeev V, Chai YL, Poh L, et al. Chronic cerebral hypoperfusion: a critical feature in unravelling the etiology of vascular cognitive impairment[J/OL]. Acta Neuropathol Commun, 2023, 11(1): 93. DOI: 10.1186/s40478-023-01590-1. |
| 28. | Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis[J]. Lancet, 2021, 397(10285): 1625-1636. |
| 29. | Howard G, Muntner P, Lackland DT, et al. Association of duration of recognized hypertension and stroke risk: the REGARDS Study[J]. Stroke, 2025, 56(1): 105-112. |
| 30. | Kaneko H, Yano Y, Lee H, et al. Blood pressure classification using the 2017 ACC/AHA guideline and heart failure in patients with cancer[J]. J Clin Oncol, 2023, 41(5): 980-990. |
| 31. | 中華醫學會麻醉學分會老年人麻醉學組, 國家老年疾病臨床醫學研究中心, 中華醫學會精神病學分會, 等. 中國老年患者圍術期腦健康多學科專家共識(一)[J]. 中華醫學雜志, 2019, 99(27): 2084-2110.Chinese Society of Anesthesiology Geriatric Anesthesia Group, National Clinical Research Center for Geriatric Diseases, Chinese Society of Psychiatry, et al. Multidisciplinary expert consensus on perioperative brain health in elderly Chinese patients (part 1)[J]. Natl Med J China, 2019, 99(27): 2084-2110. |
| 32. | Bijker JB, Persoon S, Peelen LM, et al. Intraoperative hypotension and perioperative ischemic stroke after general surgery: a nested case-control study[J]. Anesthesiology, 2012, 116(3): 658-664. |
| 33. | POISE Study Group, Devereaux PJ, Yang H, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial[J]. Lancet, 2008, 371(9627): 1839-1847. |
| 34. | Hsieh JK, Dalton JE, Yang D, et al. The association between mild intraoperative hypotension and stroke in general surgery patients[J]. Anesth Analg, 2016, 123(4): 933-939. |
| 35. | Liu S, Shi L, Wang B, et al. Preoperative hyperglycemia is associated with elevated risk of perioperative ischemic stroke in type 2 diabetic patients undergoing non-cardiovascular surgery: a retrospective cohort study[J/OL]. Front Aging Neurosci, 2022, 14: 990567. DOI: 10.3389/fnagi.2022.990567. |
| 36. | Mosenzon O, Cheng AY, Rabinstein AA, et al. Diabetes and stroke: what are the connections?[J]. J Stroke, 2023, 25(1): 26-38. |
| 37. | Saxena A, Anderson CS, Wang X, et al. Prognostic significance of hyperglycemia in acute intracerebral hemorrhage: the INTERACT2 Study[J]. Stroke, 2016, 47(3): 682-688. |
| 38. | Shi H, Ge Y, Wang H, et al. Fasting blood glucose and risk of stroke: a dose-response meta-analysis[J]. Clin Nutr, 2021, 40(5): 3296-3304. |
| 39. | 中華醫學會糖尿病學分會. 中國糖尿病防治指南(2024版)[J]. 中華糖尿病雜志, 2025, 17(1): 16-139.Chinese Diabetes Society. Guidelines for the prevention and treatment of diabetes in China (2024 edition)[J]. Chin J Diabetes, 2025, 17(1): 16-139. |
| 40. | Li J, Ji C, Zhang W, et al. Effect of new glucose-lowering drugs on stroke in patients with type 2 diabetes: a systematic review and meta-analysis[J/OL]. J Diabetes Complications, 2023, 37(1): 108362. DOI: 10.1016/j.jdiacomp.2022.108362. |
| 41. | Schernthaner G, Brand K, Bailey CJ. Metformin and the heart: update on mechanisms of cardiovascular protection with special reference to comorbid type 2 diabetes and heart failure[J/OL]. Metabolism, 2022, 130: 155160. DOI: 10.1016/j.metabol.2022.155160. |
| 42. | Chen Q, Ji Y, Wang J, et al. Risk factor analysis of postoperative cerebral infarction in thoracic surgery patients by propensity-score matching-a single institution retrospective cohort study[J]. J Thorac Dis, 2023, 15(2): 620-626. |
| 43. | Mihalj M, Heinisch PP, Huber M, et al. Effect of perioperative lipid status on clinical outcomes after cardiac surgery[J/OL]. Cells, 2021, 10(10): 2717. DOI: 10.3390/cells10102717. |
| 44. | Mach F, Koskinas KC, Roeters van Lennep JE, et al. 2025 focused update of the 2019 ESC/EAS guidelines for the management of dyslipidaemias[J]. Eur Heart J, 2025, 46(42): 4359-4378. |
| 45. | Kato ET, Cannon CP, Blazing MA, et al. Efficacy and safety of adding ezetimibe to statin therapy among women and men: insight from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)[J/OL]. J Am Heart Assoc, 2017, 6(11): e006901. DOI: 10.1161/jaha.117.006901. |
| 46. | Bohula EA, Wiviott SD, Giugliano RP, et al. Prevention of stroke with the addition of ezetimibe to statin therapy in patients with acute coronary syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)[J]. Circulation, 2017, 136(25): 2440-2450. |
| 47. | 中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 非心臟外科手術圍手術期心血管疾病管理中國專家共識[J]. 中華心血管病雜志, 2023, 51(10): 1043-1055.Chinese Society of Cardiology, Editorial Committee of Chinese Journal of Cardiology. Chinese expert consensus on perioperative cardiovascular disease management in non-cardiac surgery[J]. Chin J Cardiol, 2023, 51(10): 1043-1055. |
| 48. | Feng X, Huang C, Tong X, et al. Effect of LDL-cholesterol levels and oral atorvastatin on outcomes after pipeline therapy for intracranial aneurysms[J]. Stroke, 2025, 56(10): 3002-3013. |
| 49. | Yu C, Jiang L, Long L, et al. Atrial fibrillation in cancer patients: epidemiology, identification and management[J]. Semin Cancer Biol, 2025, 111: 39-47. |
| 50. | Murtaza M, Baig MMA, Ahmed J, et al. Higher mortality associated with new-onset atrial fibrillation in cancer patients: a systematic review and meta-analysis[J/OL]. Front Cardiovasc Med, 2022, 9: 867002. DOI: 10.3389/fcvm.2022.867002. |
| 51. | Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J/OL]. Circulation, 2024, 149(1): e1-e156. DOI: 10.1161/cir.0000000000001207. |
| 52. | Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)[J]. Eur Heart J, 2024, 45(36): 3314-3414. |
| 53. | Chao TF, Lip GY, Liu CJ, et al. Validation of a modified CHA2DS2-VASc score for stroke risk stratification in Asian patients with atrial fibrillation: a nationwide cohort study[J]. Stroke, 2016, 47(10): 2462-2469. |
| 54. | Kotalczyk A, Mazurek M, Kalarus Z, et al. Stroke prevention strategies in high-risk patients with atrial fibrillation[J]. Nat Rev Cardiol, 2021, 18(4): 276-290. |
| 55. | Burr N, Lummis K, Sood R, et al. Risk of gastrointestinal bleeding with direct oral anticoagulants: a systematic review and network meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(2): 85-93. |
| 56. | Lobo DN. The 2023 Sir David Cuthbertson Lecture. A fluid journey: experiments that influenced clinical practice[J]. Clin Nutr, 2023, 42(11): 2270-2281. |
| 57. | Haysley J, Soliman-Aboumarie H, Huang J, et al. Perioperative atrial fibrillation[J]. BJA Educ, 2025, 25(3): 99-106. |
| 58. | Kent DM, Wang AY. Patent foramen ovale and stroke: a review[J]. JAMA, 2025, 334(16): 1463-1473. |
| 59. | Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2021, 52(7): e364-e467. DOI: 10.1161/str.0000000000000383. |
| 60. | Zhou B, Alshareef M, Prim D, et al. The perivascular environment along the vertebral artery governs segment-specific structural and mechanical properties[J]. Acta Biomater, 2016, 45: 286-295. |
| 61. | Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases[J]. Eur Heart J, 2024, 45(36): 3538-3700. |
| 62. | Naylor R, Rantner B, Ancetti S, et al. Editor's choice-European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease[J]. Eur J Vasc Endovasc Surg, 2023, 65(1): 7-111. |
| 63. | 中國研究型醫院學會, 中國醫師協會神經介入專業委員會, 中國神經科學學會腦血管功能與疾病分會. 顱內動脈粥樣硬化性狹窄診治指南(2025版)[J]. 中華醫學雜志, 2025, 105(29): 2449-2468.Chinese Research Hospital Association, Neurointervention Committee of Chinese Medical Doctor Association, Cerebrovascular Function and Diseases Branch of Chinese Neuroscience Society. Guidelines for diagnosis and treatment of intracranial atherosclerotic stenosis (2025 edition)[J]. Natl Med J China, 2025, 105(29): 2449-2468. |
| 64. | Trager MH, Gordon ER, Humphreys TR, et al. Part 1: management of antithrombotic medications in dermatologic surgery[J]. J Am Acad Dermatol, 2025, 92(3): 389-404. |
| 65. | Lip GYH, Lane DA, Lenarczyk R, et al. Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke[J]. Eur Heart J, 2022, 43(26): 2442-2460. |
| 66. | Bonaca MP, Barnes GD, Bauersachs R, et al. Antithrombotic strategies for patients with peripheral artery disease: JACC scientific statement[J]. J Am Coll Cardiol, 2024, 84(10): 936-952. |
| 67. | Tarantini G, D'Amico G, Schmidt B, et al. The impact of CHA2DS2-VASc and HAS-BLED scores on clinical outcomes in the Amplatzer Amulet study[J]. JACC Cardiovasc Interv, 2020, 13(18): 2099-2108. |
| 68. | Bejjani A, Khairani CD, Assi A, et al. When direct oral anticoagulants should not be standard treatment: JACC state-of-the-art review[J]. J Am Coll Cardiol, 2024, 83(3): 444-465. |
| 69. | Douketis JD, Spyropoulos AC. Perioperative management of anticoagulant and antiplatelet therapy[J/OL]. NEJM Evid, 2023, 2(6): EVIDra2200322. DOI: 10.1161/str.0000000000000383. |
| 70. | Vlisides PE, Moore LE. Stroke in surgical patients[J]. Anesthesiology, 2021, 134(3): 480-492. |
| 71. | McKenzie NL, Ward RP, Nagele P, et al. Preoperative β-blocker therapy and stroke or major adverse cardiac events in major abdominal surgery: a retrospective cohort study[J]. Anesthesiology, 2023, 138(1): 42-54. |
| 72. | Schrage B, Lund LH, Benson L, et al. Association between a hospitalization for heart failure and the initiation/discontinuation of guideline-recommended treatments: an analysis from the Swedish Heart Failure Registry[J]. Eur J Heart Fail, 2023, 25(7): 1132-1144. |
| 73. | Herrera Hernández D, Abreu B, Xiao TS, et al. Beta-blocker use in patients undergoing non-cardiac surgery: a systematic review and meta-analysis[J/OL]. Med Sci (Basel), 2024, 12(4): 64. DOI: 10.3390/medsci12040064. |
| 74. | 中華醫學會麻醉學分會老年人麻醉與圍術期管理學組, 國家老年麻醉聯盟(NAGA), 國家老年疾病臨床醫學研究中心(宣武醫院). 中國成人患者圍手術期液體治療臨床實踐指南(2025版)[J]. 中華醫學雜志, 2025, 105(2): 128-154.Geriatric Anesthesia and Perioperative Management Group of Chinese Society of Anesthesiology, National Geriatric Anesthesia Alliance (NAGA), National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital). Clinical practice guidelines for perioperative fluid therapy in Chinese adult patients (2025 edition)[J]. Natl Med J China, 2025, 105(2): 128-154. |
| 75. | Ostermann M, Auzinger G, Grocott M, et al. Perioperative fluid management: evidence-based consensus recommendations from the international multidisciplinary PeriOperative Quality Initiative[J]. Br J Anaesth, 2024, 133(6): 1263-1275. |
| 76. | Santiago AE, Filho ALDS, Candido EB, et al. Perioperative management in gynecological surgery based on the ERAS program[J]. Rev Bras Ginecol Obstet, 2022, 44(2): 202-210. |
| 77. | Porto JR, Lavu MS, Hecht CJ, et al. Tranexamic acid lowers transfusions and readmissions in high-risk total knee arthroplasty patients, but neurologic risks remain in patients with seizures or visual disturbances[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2025. Epub ahead of print. DOI: 10.1002/ksa.70124. |
| 78. | Dean LW, Tin AL, Chesnut GT, et al. Contemporary management of hemorrhage after minimally invasive radical prostatectomy[J]. Urology, 2019, 130: 120-125. |
| 79. | Ran KR, Nair SK, Srinivas T, et al. Hemoglobin drop is associated with early post-operative stroke following revascularization surgery for moyamoya disease[J]. J Neurosurg Anesthesiol, 2025, 37(2): 174-180. |
| 80. | Mikhailova DM, Sudnitsyna J, Kovgan P, et al. Analysis of ferric protoporphyrin IX effects on human platelets: hematin is a more potent agonist than hemin[J/OL]. Cells, 2025, 14(4): 255. DOI: 10.3390/cells14040255. |
| 81. | Blauenfeldt RA, Waller J, Drasbek KR, et al. Effect of remote ischemic conditioning on the form and function of red blood cells in patients with acute ischemic stroke[J]. Stroke, 2025, 56(3): 603-612. |
| 82. | Fangma YJ, Zhou ZC, Chen Z, et al. Translational insights into pericyte-mediated regulation of cerebral blood flow: implications for ischemic stroke[J/OL]. Stroke, 2025, 56(10): e254-e266. DOI: 10.1161/strokeaha.125.052018. |
| 83. | Ali Z, Hassan N, Syed S. Blood transfusion practices in neuroanaesthesia[J]. Indian J Anaesth, 2014, 58(5): 622-628. |
| 84. | Sarraj A, Blackburn S, Abraham MG, et al. General vs nongeneral anesthesia for endovascular thrombectomy in patients with large core strokes: a prespecified secondary analysis of SELECT2 trial[J/OL]. Neurology, 2025, 105(2): e213819. DOI: 10.1212/WNL.0000000000213819. |
| 85. | Azimaraghi O, Rudolph MI, Wongtangman K, et al. Role of anticoagulation therapy in modifying stroke risk associated with new-onset atrial fibrillation after non-cardiac surgery[J]. Nat Med, 2024, 30(11): 3310-3317. |
| 86. | Jeong MJ, Kwon H, Jung CH, et al. Comparison of outcomes after carotid endarterectomy between type 2 diabetic and non-diabetic patients with significant carotid stenosis[J/OL]. Cardiovasc Diabetol, 2019, 18(1): 41. DOI: 10.1186/s12933-019-0848-7. |
| 87. | Filiberto AC, Loftus TJ, Elder CT, et al. Intraoperative hypotension and complications after vascular surgery: a scoping review[J]. Surgery, 2021, 170(1): 311-317. |
| 88. | Claassen JAHR, Thijssen DHJ, Panerai RB, et al. Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation[J]. Physiol Rev, 2021, 101(4): 1487-1559. |
| 89. | Wi?cek M, Tomaszewska-Lampart I, Dziedzic M, et al. Association between transient-continuous hypotension during mechanical thrombectomy for acute ischemic stroke and final infarct volume in patients with proximal anterior circulation large vessel occlusion[J/OL]. J Clin Med, 2024, 13(13): 3707. DOI: 10.3390/jcm13133707. |
| 90. | Huang WW, Zhu WZ, Mu DL, et al. Intraoperative hypotension is associated with shortened overall survival after lung cancer surgery[J/OL]. BMC Anesthesiol, 2020, 20(1): 160. DOI: 10.1186/s12871-020-01062-2. |
| 91. | Ferrando C, Carrami?ana A, Pi?eiro P, et al. Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial[J]. Lancet Respir Med, 2024, 12(3): 195-206. |
| 92. | Silvera F, Gagliardi T, Vollono P, et al. Study of the relationship between regional cerebral saturation and pCO2 changes during mechanical ventilation to evaluate modifications in cerebral perfusion in a newborn piglet model[J/OL]. Braz J Med Biol Res, 2022, 55: e11543. DOI: 10.1590/1414-431x2022e11543. |
| 93. | Schober A, Feiner JR, Bickler PE, et al. Effects of changes in arterial carbon dioxide and oxygen partial pressures on cerebral oximeter performance[J]. Anesthesiology, 2018, 128(1): 97-108. |
| 94. | Vlisides PE, Mentz G, Leis AM, et al. Carbon dioxide, blood pressure, and perioperative stroke: a retrospective case-control study[J]. Anesthesiology, 2022, 137(4): 434-445. |
| 95. | Kahl U, Yu Y, Nierhaus A, et al. Cerebrovascular autoregulation and arterial carbon dioxide in patients with acute respiratory distress syndrome: a prospective observational cohort study[J/OL]. Ann Intensive Care, 2021, 11(1): 47. DOI: 10.1186/s13613-021-00831-7. |
| 96. | Han J, Zhai W, Wu Z, et al. Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial[J/OL]. BMJ, 2025, 388: e082104. DOI: 10.1136/bmj-2024-082104. |
| 97. | Lim L, Nam K, Lee S, et al. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study[J/OL]. BMC Anesthesiol, 2020, 20(1): 285. DOI: 10.1186/s12871-020-01180-x. |
| 98. | Kamenskaya OV, Loginova IY, Lomivorotov VV. Brain oxygen supply parameters in the risk assessment of cerebral complications during carotid endarterectomy[J]. J Cardiothorac Vasc Anesth, 2017, 31(3): 944-949. |
| 99. | Arnold M, Sturzenegger M, Sch?ffler L, et al. Continuous intraoperative monitoring of middle cerebral artery blood flow velocities and electroencephalography during carotid endarterectomy. A comparison of the two methods to detect cerebral ischemia[J]. Stroke, 1997, 28(7): 1345-1350. |
| 100. | Brand ART, Leunissen TC, van Vriesland D, et al. Flow cytometry based platelet reactivity testing to predict the occurrence of per-operative solid microemboli during carotid endarterectomy[J]. Eur J Vasc Endovasc Surg, 2022, 63(6): 800-806. |
| 101. | Busto G, Morotti A, Carlesi E, et al. Pivotal role of multiphase computed tomography angiography for collateral assessment in patients with acute ischemic stroke[J]. Radiol Med, 2023, 128(8): 944-959. |
| 102. | van Stigt MN, Groenendijk EA, van Meenen LCC, et al. Prehospital detection of large vessel occlusion stroke with EEG[J/OL]. Neurology, 2023, 101(24): e2522-e2532. DOI: 10.1212/wnl.0000000000209587. |
| 103. | Mukai A, Yang JT, Wu SC, et al. From index to insight: clinical perspectives on electroencephalographic spectrogram-guided anesthesia-a narrative review[J]. Korean J Anesthesiol, 2026, 79(2): 139-151. |
| 104. | Mirallave Pescador A, Pérez Lorensu PJ, Saponaro González á, et al. Anaesthesia and multimodality intraoperative neuromonitoring in carotid endarterectomy. Chronological evolution and effects on intraoperative neurophysiology[J]. J Clin Monit Comput, 2021, 35(6): 1429-1436. |
| 105. | Akhondi-Asl A, Vonberg FW, Au CC, et al. Meaning of intracranial pressure-to-blood pressure Fisher-transformed Pearson correlation-derived optimal cerebral perfusion pressure: testing empiric utility in a mechanistic model[J/OL]. Crit Care Med, 2018, 46(12): e1160-e1166. DOI: 10.1097/ccm.0000000000003434. |
| 106. | J?rgensen ME, Torp-Pedersen C, Gislason GH, et al. Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery[J]. JAMA, 2014, 312(3): 269-277. |
| 107. | Eyth A, Borngaesser F, Rudolph MI, et al. Development and validation of a risk model to predict intraoperative blood transfusion[J/OL]. JAMA Netw Open, 2025, 8(4): e255522. DOI: 10.1001/jamanetworkopen.2025.5522. |
| 108. | Itting PT, Sadlonova M, Santander MJ, et al. Intra- and early postoperative predictors of delirium risk in cardiac surgery: results from the prospective observational FINDERI study[J]. Int J Surg, 2025, 111(4): 2872-2885. |
| 109. | Fletcher AJ, Tew YY, Tzolos E, et al. Thoracic aortic 18F-sodium fluoride activity and ischemic stroke in patients with established cardiovascular disease[J]. JACC Cardiovasc Imaging, 2022, 15(7): 1274-1288. |
| 110. | El-Rayes M, Nardi Agmon I, Yu C, et al. Lung cancer and cardiovascular disease: common pathophysiology and treatment-emergent toxicity[J]. JACC CardioOncol, 2025, 7(4): 325-344. |
| 111. | She R, Yan Z, Hao Y, et al. Comorbidity in patients with first-ever ischemic stroke: disease patterns and their associations with cognitive and physical function[J/OL]. Front Aging Neurosci, 2022, 14: 887032. DOI: 10.3389/fnagi.2022.887032. |
| 112. | Zhang YN, Wu Q, Cui Y, et al. Metabolic syndrome and efficacy of remote ischemic postconditioning in acute moderate ischemic stroke: a post hoc analysis of the RICAMIS trial[J/OL]. J Am Heart Assoc, 2025, 14(6): e037859. DOI: 10.1161/jaha.124.037859. |
| 113. | Ueno H, Yamaoka H, Hirai S, et al. Endovascular treatment for acute ischemic stroke after video-assisted thoracoscopic pulmonary lobectomy in patients with lung cancer: a report of four cases and literature review[J/OL]. J Stroke Cerebrovasc Dis, 2022, 31(8): 106593. DOI: 10.1016/j.jstrokecerebrovasdis.2022.106593. |
| 114. | Williams J, Taylor M. Cerebral infarction after lung resection: is it predictable or just a stroke of bad luck[J]? J Thorac Dis, 2023, 15(12): 6390-6394. |
| 115. | Hashimoto H, Usui G, Tsugeno Y, et al. Cerebral thromboembolism after lobectomy for lung cancer: pathological diagnosis and mechanism of thrombus formation[J/OL]. Cancers (Basel), 2019, 11(4): 488. DOI: 10.3390/cancers11040488. |
| 116. | Egawa J, Inoue S, Nishiwada T, et al. Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial[J]. Can J Anaesth, 2016, 63(10): 1161-1169. |
| 117. | Ding HG, Li Y, Li XS, et al. Hypercapnia promotes microglial pyroptosis via inhibiting mitophagy in hypoxemic adult rats[J]. CNS Neurosci Ther, 2020, 26(11): 1134-1146. |
| 118. | Liang X, Li P, Qin Y, et al. Excessive lymph node dissection increases postoperative cardiovascular disease risk in non-small cell lung cancer patients[J/OL]. Sci Rep, 2025, 15(1): 5698. DOI: 10.1038/s41598-025-90052-w. |
| 119. | Park JE, Cha SI, Lee DH, et al. Pulmonary vein stump thrombosis after lung resection for lung cancer: clinical features and outcome[J]. Blood Coagul Fibrinolysis, 2022, 33(6): 295-300. |
| 120. | Yan X, Pang Y, Yan L, et al. Perioperative stroke in patients undergoing spinal surgery: a retrospective cohort study[J/OL]. BMC Musculoskelet Disord, 2022, 23(1): 652. DOI: 10.1186/s12891-022-05591-4. |
| 121. | Flexman AM, Kim CNH, Plyley T, et al. Postoperative screening with the modified National Institutes of Health Stroke Scale after noncardiac surgery: a pilot study[J]. J Neurosurg Anesthesiol, 2022, 34(3): 327-332. |
| 122. | Bouchereau E, Pruvost-Robieux E, Siami S, et al. Altered lower brainstem neurophysiological response is associated with mortality in deeply sedated critically ill patients[J]. Intensive Care Med, 2025, 51(6): 1050-1061. |
| 123. | Taylor J, Eisenmenger L, Lindroth H, et al. Perioperative ischaemic brain injury and plasma neurofilament light: a secondary analysis of two prospective cohort studies[J/OL]. Br J Anaesth, 2023, 130(2): e361-e369. DOI: 10.1016/j.bja.2022.10.018. |
| 124. | Favata A, Gallart-Agut R, van Noort L, et al. IMU-based kinematic analysis to enhance upper limb motor function assessment in neuromuscular diseases[J/OL]. J Neuroeng Rehabil, 2025, 22(1): 63. DOI: 10.1186/s12984-025-01602-2. |
| 125. | Shu'aibu Hikima M, Idris N, Suwaid MA, et al. Variation between imaging and non-imaging transcranial Doppler systems versus a phantom Doppler generated velocity[J]. Am J Hematol, 2025, 100(4): 744-746. |
| 126. | 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性卒中診治指南(2023版)[J]. 中華神經科雜志, 2024, 57(6): 523-559.Chinese Society of Neurology, Cerebrovascular Disease Group of Chinese Society of Neurology. Chinese guidelines for diagnosis and treatment of acute ischemic stroke (2023 edition)[J]. Chin J Neurol, 2024, 57(6): 523-559. |
| 127. | Yuen MM, Prabhat AM, Mazurek MH, et al. Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke[J/OL]. Sci Adv, 2022, 8(16): eabm3952. DOI: 10.1126/sciadv.abm3952. |
| 128. | Kim JH, Noh Y, Lee H, et al. Toward automated detection of microbleeds with anatomical scale localization using deep learning[J/OL]. Med Image Anal, 2025, 101: 103415. DOI: 10.1016/j.media.2024.103415. |
| 129. | Xia Y, Ravikumar N, Lassila T, et al. Virtual high-resolution MR angiography from non-angiographic multi-contrast MRIs: synthetic vascular model populations for in-silico trials[J/OL]. Med Image Anal, 2023, 87: 102814. DOI: 10.1016/j.media.2023.102814. |
| 130. | 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南2018[J]. 中華神經科雜志, 2018, 51(9): 666-682.Chinese Society of Neurology, Cerebrovascular Disease Group of Chinese Society of Neurology. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chin J Neurol, 2018, 51(9): 666-682. |
| 131. | Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2019, 50(12): e344-e418. DOI: 10.1161/STR.0000000000000211. |
| 132. | Mendelson SJ, Prabhakaran S. Diagnosis and management of transient ischemic attack and acute ischemic stroke: a review[J]. JAMA, 2021, 325(11): 1088-1098. |
| 133. | Kürten S, Munoz C, Beseoglu K, et al. Decompressive hemicraniectomy for malignant middle cerebral artery infarction including patients with additional involvement of the anterior and/or posterior cerebral artery territory-outcome analysis and definition of prognostic factors[J]. Acta Neurochir (Wien), 2018, 160(1): 83-89. |
| 134. | Pallesen LP, Barlinn K, Puetz V. Role of decompressive craniectomy in ischemic stroke[J/OL]. Front Neurol, 2019, 9: 1119. DOI: 10.3389/fneur.2018.01119. |
| 135. | Chen HS, Cui Y, Li XQ, et al. Effect of remote ischemic conditioning vs usual care on neurologic function in patients with acute moderate ischemic stroke: the RICAMIS randomized clinical trial[J]. JAMA, 2022, 328(7): 627-636. |
- 1. Nishizawa N, Okawara M, Mori M, et al. Postoperative cerebral infarction risk is related to lobectomy site in lung cancer: a retrospective cohort study of nationwide data in Japan[J/OL]. BMJ Open Respir Res, 2022, 9(1): e001327. DOI: 10.1136/bmjresp-2022-001327.
- 2. Zhou Y, Wang X, Yin W, et al. Perioperative stroke deteriorates white matter integrity by enhancing cytotoxic CD8+ T-cell activation[J/OL]. CNS Neurosci Ther, 2024, 30(7): e14747. DOI: 10.1111/cns.14747.
- 3. Bushnell C, Kernan WN, Sharrief AZ, et al. 2024 guideline for the primary prevention of stroke: a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2024, 55(12): e344-e424. DOI: 10.1161/str.0000000000000482.
- 4. Vlisides PE, Moore LE, Whalin MK, et al. Perioperative care of patients at high risk for stroke during or after non-cardiac, non-neurological surgery: 2020 guidelines from the Society for Neuroscience in Anesthesiology and Critical Care[J]. J Neurosurg Anesthesiol, 2020, 32(3): 210-226.
- 5. Quinlan M, Arora R, Cho SM. Postoperative Brain Attack: Current Perspectives and Future Directions[J]. Semin Thorac Cardiovasc Surg, 2025, 37(3): 281-292.
- 6. Al-Hader R, Al-Robaidi K, Jovin T, et al. The incidence of perioperative stroke: estimate using state and national databases and systematic review[J]. J Stroke, 2019, 21(3): 290-301.
- 7. Benesch C, Glance LG, Derdeyn CP, et al. Perioperative neurological evaluation and management to lower the risk of acute stroke in patients undergoing noncardiac, nonneurological surgery: a scientific statement from the American Heart Association/American Stroke Association[J/OL]. Circulation, 2021, 143(19): e923-e946. DOI: 10.1161/cir.0000000000000968.
- 8. Shu L, Aziz YN, de Havenon A, et al. Perioperative stroke: mechanisms, risk stratification, and management[J]. Stroke, 2025, 56(9): 2798-2809.
- 9. Marcucci M, Chan MTV, Smith EE, et al. Prevention of perioperative stroke in patients undergoing non-cardiac surgery[J]. Lancet Neurol, 2023, 22(10): 946-958.
- 10. Yoo J, Kwon I, Kim S, et al. Coagulation factor expression and composition of arterial thrombi in cancer-associated stroke[J]. Stroke, 2023, 54(12): 2981-2989.
- 11. Riddersholm S, Tayal B, Kragholm K, et al. Incidence of stroke after pneumonectomy and lobectomy[J]. Stroke, 2019, 50(5): 1052-1059.
- 12. Rousseau J, Wen PY. Cerebrovascular and peripheral vascular complications in cancer patients[J/OL]. Curr Neurol Neurosci Rep, 2025, 25(1): 46. DOI: 10.1007/s11910-025-01434-6.
- 13. Navi BB, Reiner AS, Kamel H, et al. Risk of arterial thromboembolism in patients with cancer[J]. J Am Coll Cardiol, 2017, 70(8): 926-938.
- 14. Khorvash F, Khalili M, Rezvani Habibabadi R, et al. Comparison of acute ischemic stroke evaluation and the etiologic subtypes between university and nonuniversity hospitals in Isfahan, Iran[J]. Int J Stroke, 2019, 14(6): 613-619.
- 15. Li L, Scott CA, Rothwell PM. Association of younger vs. older ages with changes in incidence of stroke and other vascular events, 2002-2018[J]. JAMA, 2022, 328(6): 563-574.
- 16. Devereaux PJ, Marcucci M. Perioperative covert stroke: acutely asymptomatic but not benign[J]. Anesthesiology, 2025, 142(3): 431-433.
- 17. Cui Q, Zhao W, Chen H, et al. Covert perioperative strokes in older patients having noncardiac surgery (PRECISION): a prospective cohort analysis[J]. Anesthesiology, 2025, 142(3): 443-453.
- 18. Fanning JP, Campbell BCV, Bulbulia R, et al. Perioperative stroke[J/OL]. Nat Rev Dis Primers, 2024, 10(1): 3. DOI: 10.1038/s41572-023-00487-6.
- 19. Kwon S, Lee SR, Choi EK, et al. Association between atrial fibrillation and diabetes-related complications: a nationwide cohort study[J]. Diabetes Care, 2023, 46(12): 2240-2248.
- 20. Chyou JY, Barkoudah E, Dukes JW, et al. Atrial fibrillation occurring during acute hospitalization: a scientific statement from the American Heart Association[J/OL]. Circulation, 2023, 147(15): e676-e698. DOI: 10.1161/cir.0000000000001147.
- 21. Goeller JK, Bartels K. Improving prediction to prevent perioperative morbidity[J]. Br J Anaesth, 2021, 127(5): 671-674.
- 22. Glance LG, Benesch CG, Holloway RG, et al. Association of time elapsed since ischemic stroke with risk of recurrent stroke in older patients undergoing elective nonneurologic, noncardiac surgery[J/OL]. JAMA Surg, 2022, 157(8): e222236. DOI: 10.1001/jamasurg.2022.2236.
- 23. Leung YYR, Bera K, Urriza Rodriguez D, et al. Safety of carotid endarterectomy for symptomatic stenosis by age: meta-analysis with individual patient data[J]. Stroke, 2023, 54(2): 457-467.
- 24. Kernan WN, Viera AJ, Billinger SA, et al. Primary care of adult patients after stroke: a scientific statement from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2021, 52(9): e558-e571. DOI: 10.1161/str.0000000000000382.
- 25. Seiffge DJ, Cancelloni V, R?ber L, et al. Secondary stroke prevention in people with atrial fibrillation: treatments and trials[J]. Lancet Neurol, 2024, 23(4): 404-417.
- 26. Nies KPH, Smits LJM, van Kuijk SMJ, et al. Individualized MRI-based stroke prediction score using plaque vulnerability for symptomatic carotid artery disease patients (IMPROVE)[J]. Stroke, 2025, 56(8): 2068-2078.
- 27. Rajeev V, Chai YL, Poh L, et al. Chronic cerebral hypoperfusion: a critical feature in unravelling the etiology of vascular cognitive impairment[J/OL]. Acta Neuropathol Commun, 2023, 11(1): 93. DOI: 10.1186/s40478-023-01590-1.
- 28. Blood Pressure Lowering Treatment Trialists' Collaboration. Pharmacological blood pressure lowering for primary and secondary prevention of cardiovascular disease across different levels of blood pressure: an individual participant-level data meta-analysis[J]. Lancet, 2021, 397(10285): 1625-1636.
- 29. Howard G, Muntner P, Lackland DT, et al. Association of duration of recognized hypertension and stroke risk: the REGARDS Study[J]. Stroke, 2025, 56(1): 105-112.
- 30. Kaneko H, Yano Y, Lee H, et al. Blood pressure classification using the 2017 ACC/AHA guideline and heart failure in patients with cancer[J]. J Clin Oncol, 2023, 41(5): 980-990.
- 31. 中華醫學會麻醉學分會老年人麻醉學組, 國家老年疾病臨床醫學研究中心, 中華醫學會精神病學分會, 等. 中國老年患者圍術期腦健康多學科專家共識(一)[J]. 中華醫學雜志, 2019, 99(27): 2084-2110.Chinese Society of Anesthesiology Geriatric Anesthesia Group, National Clinical Research Center for Geriatric Diseases, Chinese Society of Psychiatry, et al. Multidisciplinary expert consensus on perioperative brain health in elderly Chinese patients (part 1)[J]. Natl Med J China, 2019, 99(27): 2084-2110.
- 32. Bijker JB, Persoon S, Peelen LM, et al. Intraoperative hypotension and perioperative ischemic stroke after general surgery: a nested case-control study[J]. Anesthesiology, 2012, 116(3): 658-664.
- 33. POISE Study Group, Devereaux PJ, Yang H, et al. Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery (POISE trial): a randomised controlled trial[J]. Lancet, 2008, 371(9627): 1839-1847.
- 34. Hsieh JK, Dalton JE, Yang D, et al. The association between mild intraoperative hypotension and stroke in general surgery patients[J]. Anesth Analg, 2016, 123(4): 933-939.
- 35. Liu S, Shi L, Wang B, et al. Preoperative hyperglycemia is associated with elevated risk of perioperative ischemic stroke in type 2 diabetic patients undergoing non-cardiovascular surgery: a retrospective cohort study[J/OL]. Front Aging Neurosci, 2022, 14: 990567. DOI: 10.3389/fnagi.2022.990567.
- 36. Mosenzon O, Cheng AY, Rabinstein AA, et al. Diabetes and stroke: what are the connections?[J]. J Stroke, 2023, 25(1): 26-38.
- 37. Saxena A, Anderson CS, Wang X, et al. Prognostic significance of hyperglycemia in acute intracerebral hemorrhage: the INTERACT2 Study[J]. Stroke, 2016, 47(3): 682-688.
- 38. Shi H, Ge Y, Wang H, et al. Fasting blood glucose and risk of stroke: a dose-response meta-analysis[J]. Clin Nutr, 2021, 40(5): 3296-3304.
- 39. 中華醫學會糖尿病學分會. 中國糖尿病防治指南(2024版)[J]. 中華糖尿病雜志, 2025, 17(1): 16-139.Chinese Diabetes Society. Guidelines for the prevention and treatment of diabetes in China (2024 edition)[J]. Chin J Diabetes, 2025, 17(1): 16-139.
- 40. Li J, Ji C, Zhang W, et al. Effect of new glucose-lowering drugs on stroke in patients with type 2 diabetes: a systematic review and meta-analysis[J/OL]. J Diabetes Complications, 2023, 37(1): 108362. DOI: 10.1016/j.jdiacomp.2022.108362.
- 41. Schernthaner G, Brand K, Bailey CJ. Metformin and the heart: update on mechanisms of cardiovascular protection with special reference to comorbid type 2 diabetes and heart failure[J/OL]. Metabolism, 2022, 130: 155160. DOI: 10.1016/j.metabol.2022.155160.
- 42. Chen Q, Ji Y, Wang J, et al. Risk factor analysis of postoperative cerebral infarction in thoracic surgery patients by propensity-score matching-a single institution retrospective cohort study[J]. J Thorac Dis, 2023, 15(2): 620-626.
- 43. Mihalj M, Heinisch PP, Huber M, et al. Effect of perioperative lipid status on clinical outcomes after cardiac surgery[J/OL]. Cells, 2021, 10(10): 2717. DOI: 10.3390/cells10102717.
- 44. Mach F, Koskinas KC, Roeters van Lennep JE, et al. 2025 focused update of the 2019 ESC/EAS guidelines for the management of dyslipidaemias[J]. Eur Heart J, 2025, 46(42): 4359-4378.
- 45. Kato ET, Cannon CP, Blazing MA, et al. Efficacy and safety of adding ezetimibe to statin therapy among women and men: insight from IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)[J/OL]. J Am Heart Assoc, 2017, 6(11): e006901. DOI: 10.1161/jaha.117.006901.
- 46. Bohula EA, Wiviott SD, Giugliano RP, et al. Prevention of stroke with the addition of ezetimibe to statin therapy in patients with acute coronary syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)[J]. Circulation, 2017, 136(25): 2440-2450.
- 47. 中華醫學會心血管病學分會, 中華心血管病雜志編輯委員會. 非心臟外科手術圍手術期心血管疾病管理中國專家共識[J]. 中華心血管病雜志, 2023, 51(10): 1043-1055.Chinese Society of Cardiology, Editorial Committee of Chinese Journal of Cardiology. Chinese expert consensus on perioperative cardiovascular disease management in non-cardiac surgery[J]. Chin J Cardiol, 2023, 51(10): 1043-1055.
- 48. Feng X, Huang C, Tong X, et al. Effect of LDL-cholesterol levels and oral atorvastatin on outcomes after pipeline therapy for intracranial aneurysms[J]. Stroke, 2025, 56(10): 3002-3013.
- 49. Yu C, Jiang L, Long L, et al. Atrial fibrillation in cancer patients: epidemiology, identification and management[J]. Semin Cancer Biol, 2025, 111: 39-47.
- 50. Murtaza M, Baig MMA, Ahmed J, et al. Higher mortality associated with new-onset atrial fibrillation in cancer patients: a systematic review and meta-analysis[J/OL]. Front Cardiovasc Med, 2022, 9: 867002. DOI: 10.3389/fcvm.2022.867002.
- 51. Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines[J/OL]. Circulation, 2024, 149(1): e1-e156. DOI: 10.1161/cir.0000000000001207.
- 52. Van Gelder IC, Rienstra M, Bunting KV, et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)[J]. Eur Heart J, 2024, 45(36): 3314-3414.
- 53. Chao TF, Lip GY, Liu CJ, et al. Validation of a modified CHA2DS2-VASc score for stroke risk stratification in Asian patients with atrial fibrillation: a nationwide cohort study[J]. Stroke, 2016, 47(10): 2462-2469.
- 54. Kotalczyk A, Mazurek M, Kalarus Z, et al. Stroke prevention strategies in high-risk patients with atrial fibrillation[J]. Nat Rev Cardiol, 2021, 18(4): 276-290.
- 55. Burr N, Lummis K, Sood R, et al. Risk of gastrointestinal bleeding with direct oral anticoagulants: a systematic review and network meta-analysis[J]. Lancet Gastroenterol Hepatol, 2017, 2(2): 85-93.
- 56. Lobo DN. The 2023 Sir David Cuthbertson Lecture. A fluid journey: experiments that influenced clinical practice[J]. Clin Nutr, 2023, 42(11): 2270-2281.
- 57. Haysley J, Soliman-Aboumarie H, Huang J, et al. Perioperative atrial fibrillation[J]. BJA Educ, 2025, 25(3): 99-106.
- 58. Kent DM, Wang AY. Patent foramen ovale and stroke: a review[J]. JAMA, 2025, 334(16): 1463-1473.
- 59. Kleindorfer DO, Towfighi A, Chaturvedi S, et al. 2021 guideline for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2021, 52(7): e364-e467. DOI: 10.1161/str.0000000000000383.
- 60. Zhou B, Alshareef M, Prim D, et al. The perivascular environment along the vertebral artery governs segment-specific structural and mechanical properties[J]. Acta Biomater, 2016, 45: 286-295.
- 61. Mazzolai L, Teixido-Tura G, Lanzi S, et al. 2024 ESC guidelines for the management of peripheral arterial and aortic diseases[J]. Eur Heart J, 2024, 45(36): 3538-3700.
- 62. Naylor R, Rantner B, Ancetti S, et al. Editor's choice-European Society for Vascular Surgery (ESVS) 2023 clinical practice guidelines on the management of atherosclerotic carotid and vertebral artery disease[J]. Eur J Vasc Endovasc Surg, 2023, 65(1): 7-111.
- 63. 中國研究型醫院學會, 中國醫師協會神經介入專業委員會, 中國神經科學學會腦血管功能與疾病分會. 顱內動脈粥樣硬化性狹窄診治指南(2025版)[J]. 中華醫學雜志, 2025, 105(29): 2449-2468.Chinese Research Hospital Association, Neurointervention Committee of Chinese Medical Doctor Association, Cerebrovascular Function and Diseases Branch of Chinese Neuroscience Society. Guidelines for diagnosis and treatment of intracranial atherosclerotic stenosis (2025 edition)[J]. Natl Med J China, 2025, 105(29): 2449-2468.
- 64. Trager MH, Gordon ER, Humphreys TR, et al. Part 1: management of antithrombotic medications in dermatologic surgery[J]. J Am Acad Dermatol, 2025, 92(3): 389-404.
- 65. Lip GYH, Lane DA, Lenarczyk R, et al. Integrated care for optimizing the management of stroke and associated heart disease: a position paper of the European Society of Cardiology Council on Stroke[J]. Eur Heart J, 2022, 43(26): 2442-2460.
- 66. Bonaca MP, Barnes GD, Bauersachs R, et al. Antithrombotic strategies for patients with peripheral artery disease: JACC scientific statement[J]. J Am Coll Cardiol, 2024, 84(10): 936-952.
- 67. Tarantini G, D'Amico G, Schmidt B, et al. The impact of CHA2DS2-VASc and HAS-BLED scores on clinical outcomes in the Amplatzer Amulet study[J]. JACC Cardiovasc Interv, 2020, 13(18): 2099-2108.
- 68. Bejjani A, Khairani CD, Assi A, et al. When direct oral anticoagulants should not be standard treatment: JACC state-of-the-art review[J]. J Am Coll Cardiol, 2024, 83(3): 444-465.
- 69. Douketis JD, Spyropoulos AC. Perioperative management of anticoagulant and antiplatelet therapy[J/OL]. NEJM Evid, 2023, 2(6): EVIDra2200322. DOI: 10.1161/str.0000000000000383.
- 70. Vlisides PE, Moore LE. Stroke in surgical patients[J]. Anesthesiology, 2021, 134(3): 480-492.
- 71. McKenzie NL, Ward RP, Nagele P, et al. Preoperative β-blocker therapy and stroke or major adverse cardiac events in major abdominal surgery: a retrospective cohort study[J]. Anesthesiology, 2023, 138(1): 42-54.
- 72. Schrage B, Lund LH, Benson L, et al. Association between a hospitalization for heart failure and the initiation/discontinuation of guideline-recommended treatments: an analysis from the Swedish Heart Failure Registry[J]. Eur J Heart Fail, 2023, 25(7): 1132-1144.
- 73. Herrera Hernández D, Abreu B, Xiao TS, et al. Beta-blocker use in patients undergoing non-cardiac surgery: a systematic review and meta-analysis[J/OL]. Med Sci (Basel), 2024, 12(4): 64. DOI: 10.3390/medsci12040064.
- 74. 中華醫學會麻醉學分會老年人麻醉與圍術期管理學組, 國家老年麻醉聯盟(NAGA), 國家老年疾病臨床醫學研究中心(宣武醫院). 中國成人患者圍手術期液體治療臨床實踐指南(2025版)[J]. 中華醫學雜志, 2025, 105(2): 128-154.Geriatric Anesthesia and Perioperative Management Group of Chinese Society of Anesthesiology, National Geriatric Anesthesia Alliance (NAGA), National Clinical Research Center for Geriatric Diseases (Xuanwu Hospital). Clinical practice guidelines for perioperative fluid therapy in Chinese adult patients (2025 edition)[J]. Natl Med J China, 2025, 105(2): 128-154.
- 75. Ostermann M, Auzinger G, Grocott M, et al. Perioperative fluid management: evidence-based consensus recommendations from the international multidisciplinary PeriOperative Quality Initiative[J]. Br J Anaesth, 2024, 133(6): 1263-1275.
- 76. Santiago AE, Filho ALDS, Candido EB, et al. Perioperative management in gynecological surgery based on the ERAS program[J]. Rev Bras Ginecol Obstet, 2022, 44(2): 202-210.
- 77. Porto JR, Lavu MS, Hecht CJ, et al. Tranexamic acid lowers transfusions and readmissions in high-risk total knee arthroplasty patients, but neurologic risks remain in patients with seizures or visual disturbances[J/OL]. Knee Surg Sports Traumatol Arthrosc, 2025. Epub ahead of print. DOI: 10.1002/ksa.70124.
- 78. Dean LW, Tin AL, Chesnut GT, et al. Contemporary management of hemorrhage after minimally invasive radical prostatectomy[J]. Urology, 2019, 130: 120-125.
- 79. Ran KR, Nair SK, Srinivas T, et al. Hemoglobin drop is associated with early post-operative stroke following revascularization surgery for moyamoya disease[J]. J Neurosurg Anesthesiol, 2025, 37(2): 174-180.
- 80. Mikhailova DM, Sudnitsyna J, Kovgan P, et al. Analysis of ferric protoporphyrin IX effects on human platelets: hematin is a more potent agonist than hemin[J/OL]. Cells, 2025, 14(4): 255. DOI: 10.3390/cells14040255.
- 81. Blauenfeldt RA, Waller J, Drasbek KR, et al. Effect of remote ischemic conditioning on the form and function of red blood cells in patients with acute ischemic stroke[J]. Stroke, 2025, 56(3): 603-612.
- 82. Fangma YJ, Zhou ZC, Chen Z, et al. Translational insights into pericyte-mediated regulation of cerebral blood flow: implications for ischemic stroke[J/OL]. Stroke, 2025, 56(10): e254-e266. DOI: 10.1161/strokeaha.125.052018.
- 83. Ali Z, Hassan N, Syed S. Blood transfusion practices in neuroanaesthesia[J]. Indian J Anaesth, 2014, 58(5): 622-628.
- 84. Sarraj A, Blackburn S, Abraham MG, et al. General vs nongeneral anesthesia for endovascular thrombectomy in patients with large core strokes: a prespecified secondary analysis of SELECT2 trial[J/OL]. Neurology, 2025, 105(2): e213819. DOI: 10.1212/WNL.0000000000213819.
- 85. Azimaraghi O, Rudolph MI, Wongtangman K, et al. Role of anticoagulation therapy in modifying stroke risk associated with new-onset atrial fibrillation after non-cardiac surgery[J]. Nat Med, 2024, 30(11): 3310-3317.
- 86. Jeong MJ, Kwon H, Jung CH, et al. Comparison of outcomes after carotid endarterectomy between type 2 diabetic and non-diabetic patients with significant carotid stenosis[J/OL]. Cardiovasc Diabetol, 2019, 18(1): 41. DOI: 10.1186/s12933-019-0848-7.
- 87. Filiberto AC, Loftus TJ, Elder CT, et al. Intraoperative hypotension and complications after vascular surgery: a scoping review[J]. Surgery, 2021, 170(1): 311-317.
- 88. Claassen JAHR, Thijssen DHJ, Panerai RB, et al. Regulation of cerebral blood flow in humans: physiology and clinical implications of autoregulation[J]. Physiol Rev, 2021, 101(4): 1487-1559.
- 89. Wi?cek M, Tomaszewska-Lampart I, Dziedzic M, et al. Association between transient-continuous hypotension during mechanical thrombectomy for acute ischemic stroke and final infarct volume in patients with proximal anterior circulation large vessel occlusion[J/OL]. J Clin Med, 2024, 13(13): 3707. DOI: 10.3390/jcm13133707.
- 90. Huang WW, Zhu WZ, Mu DL, et al. Intraoperative hypotension is associated with shortened overall survival after lung cancer surgery[J/OL]. BMC Anesthesiol, 2020, 20(1): 160. DOI: 10.1186/s12871-020-01062-2.
- 91. Ferrando C, Carrami?ana A, Pi?eiro P, et al. Individualised, perioperative open-lung ventilation strategy during one-lung ventilation (iPROVE-OLV): a multicentre, randomised, controlled clinical trial[J]. Lancet Respir Med, 2024, 12(3): 195-206.
- 92. Silvera F, Gagliardi T, Vollono P, et al. Study of the relationship between regional cerebral saturation and pCO2 changes during mechanical ventilation to evaluate modifications in cerebral perfusion in a newborn piglet model[J/OL]. Braz J Med Biol Res, 2022, 55: e11543. DOI: 10.1590/1414-431x2022e11543.
- 93. Schober A, Feiner JR, Bickler PE, et al. Effects of changes in arterial carbon dioxide and oxygen partial pressures on cerebral oximeter performance[J]. Anesthesiology, 2018, 128(1): 97-108.
- 94. Vlisides PE, Mentz G, Leis AM, et al. Carbon dioxide, blood pressure, and perioperative stroke: a retrospective case-control study[J]. Anesthesiology, 2022, 137(4): 434-445.
- 95. Kahl U, Yu Y, Nierhaus A, et al. Cerebrovascular autoregulation and arterial carbon dioxide in patients with acute respiratory distress syndrome: a prospective observational cohort study[J/OL]. Ann Intensive Care, 2021, 11(1): 47. DOI: 10.1186/s13613-021-00831-7.
- 96. Han J, Zhai W, Wu Z, et al. Care guided by tissue oxygenation and haemodynamic monitoring in off-pump coronary artery bypass grafting (Bottomline-CS): assessor blind, single centre, randomised controlled trial[J/OL]. BMJ, 2025, 388: e082104. DOI: 10.1136/bmj-2024-082104.
- 97. Lim L, Nam K, Lee S, et al. The relationship between intraoperative cerebral oximetry and postoperative delirium in patients undergoing off-pump coronary artery bypass graft surgery: a retrospective study[J/OL]. BMC Anesthesiol, 2020, 20(1): 285. DOI: 10.1186/s12871-020-01180-x.
- 98. Kamenskaya OV, Loginova IY, Lomivorotov VV. Brain oxygen supply parameters in the risk assessment of cerebral complications during carotid endarterectomy[J]. J Cardiothorac Vasc Anesth, 2017, 31(3): 944-949.
- 99. Arnold M, Sturzenegger M, Sch?ffler L, et al. Continuous intraoperative monitoring of middle cerebral artery blood flow velocities and electroencephalography during carotid endarterectomy. A comparison of the two methods to detect cerebral ischemia[J]. Stroke, 1997, 28(7): 1345-1350.
- 100. Brand ART, Leunissen TC, van Vriesland D, et al. Flow cytometry based platelet reactivity testing to predict the occurrence of per-operative solid microemboli during carotid endarterectomy[J]. Eur J Vasc Endovasc Surg, 2022, 63(6): 800-806.
- 101. Busto G, Morotti A, Carlesi E, et al. Pivotal role of multiphase computed tomography angiography for collateral assessment in patients with acute ischemic stroke[J]. Radiol Med, 2023, 128(8): 944-959.
- 102. van Stigt MN, Groenendijk EA, van Meenen LCC, et al. Prehospital detection of large vessel occlusion stroke with EEG[J/OL]. Neurology, 2023, 101(24): e2522-e2532. DOI: 10.1212/wnl.0000000000209587.
- 103. Mukai A, Yang JT, Wu SC, et al. From index to insight: clinical perspectives on electroencephalographic spectrogram-guided anesthesia-a narrative review[J]. Korean J Anesthesiol, 2026, 79(2): 139-151.
- 104. Mirallave Pescador A, Pérez Lorensu PJ, Saponaro González á, et al. Anaesthesia and multimodality intraoperative neuromonitoring in carotid endarterectomy. Chronological evolution and effects on intraoperative neurophysiology[J]. J Clin Monit Comput, 2021, 35(6): 1429-1436.
- 105. Akhondi-Asl A, Vonberg FW, Au CC, et al. Meaning of intracranial pressure-to-blood pressure Fisher-transformed Pearson correlation-derived optimal cerebral perfusion pressure: testing empiric utility in a mechanistic model[J/OL]. Crit Care Med, 2018, 46(12): e1160-e1166. DOI: 10.1097/ccm.0000000000003434.
- 106. J?rgensen ME, Torp-Pedersen C, Gislason GH, et al. Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery[J]. JAMA, 2014, 312(3): 269-277.
- 107. Eyth A, Borngaesser F, Rudolph MI, et al. Development and validation of a risk model to predict intraoperative blood transfusion[J/OL]. JAMA Netw Open, 2025, 8(4): e255522. DOI: 10.1001/jamanetworkopen.2025.5522.
- 108. Itting PT, Sadlonova M, Santander MJ, et al. Intra- and early postoperative predictors of delirium risk in cardiac surgery: results from the prospective observational FINDERI study[J]. Int J Surg, 2025, 111(4): 2872-2885.
- 109. Fletcher AJ, Tew YY, Tzolos E, et al. Thoracic aortic 18F-sodium fluoride activity and ischemic stroke in patients with established cardiovascular disease[J]. JACC Cardiovasc Imaging, 2022, 15(7): 1274-1288.
- 110. El-Rayes M, Nardi Agmon I, Yu C, et al. Lung cancer and cardiovascular disease: common pathophysiology and treatment-emergent toxicity[J]. JACC CardioOncol, 2025, 7(4): 325-344.
- 111. She R, Yan Z, Hao Y, et al. Comorbidity in patients with first-ever ischemic stroke: disease patterns and their associations with cognitive and physical function[J/OL]. Front Aging Neurosci, 2022, 14: 887032. DOI: 10.3389/fnagi.2022.887032.
- 112. Zhang YN, Wu Q, Cui Y, et al. Metabolic syndrome and efficacy of remote ischemic postconditioning in acute moderate ischemic stroke: a post hoc analysis of the RICAMIS trial[J/OL]. J Am Heart Assoc, 2025, 14(6): e037859. DOI: 10.1161/jaha.124.037859.
- 113. Ueno H, Yamaoka H, Hirai S, et al. Endovascular treatment for acute ischemic stroke after video-assisted thoracoscopic pulmonary lobectomy in patients with lung cancer: a report of four cases and literature review[J/OL]. J Stroke Cerebrovasc Dis, 2022, 31(8): 106593. DOI: 10.1016/j.jstrokecerebrovasdis.2022.106593.
- 114. Williams J, Taylor M. Cerebral infarction after lung resection: is it predictable or just a stroke of bad luck[J]? J Thorac Dis, 2023, 15(12): 6390-6394.
- 115. Hashimoto H, Usui G, Tsugeno Y, et al. Cerebral thromboembolism after lobectomy for lung cancer: pathological diagnosis and mechanism of thrombus formation[J/OL]. Cancers (Basel), 2019, 11(4): 488. DOI: 10.3390/cancers11040488.
- 116. Egawa J, Inoue S, Nishiwada T, et al. Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial[J]. Can J Anaesth, 2016, 63(10): 1161-1169.
- 117. Ding HG, Li Y, Li XS, et al. Hypercapnia promotes microglial pyroptosis via inhibiting mitophagy in hypoxemic adult rats[J]. CNS Neurosci Ther, 2020, 26(11): 1134-1146.
- 118. Liang X, Li P, Qin Y, et al. Excessive lymph node dissection increases postoperative cardiovascular disease risk in non-small cell lung cancer patients[J/OL]. Sci Rep, 2025, 15(1): 5698. DOI: 10.1038/s41598-025-90052-w.
- 119. Park JE, Cha SI, Lee DH, et al. Pulmonary vein stump thrombosis after lung resection for lung cancer: clinical features and outcome[J]. Blood Coagul Fibrinolysis, 2022, 33(6): 295-300.
- 120. Yan X, Pang Y, Yan L, et al. Perioperative stroke in patients undergoing spinal surgery: a retrospective cohort study[J/OL]. BMC Musculoskelet Disord, 2022, 23(1): 652. DOI: 10.1186/s12891-022-05591-4.
- 121. Flexman AM, Kim CNH, Plyley T, et al. Postoperative screening with the modified National Institutes of Health Stroke Scale after noncardiac surgery: a pilot study[J]. J Neurosurg Anesthesiol, 2022, 34(3): 327-332.
- 122. Bouchereau E, Pruvost-Robieux E, Siami S, et al. Altered lower brainstem neurophysiological response is associated with mortality in deeply sedated critically ill patients[J]. Intensive Care Med, 2025, 51(6): 1050-1061.
- 123. Taylor J, Eisenmenger L, Lindroth H, et al. Perioperative ischaemic brain injury and plasma neurofilament light: a secondary analysis of two prospective cohort studies[J/OL]. Br J Anaesth, 2023, 130(2): e361-e369. DOI: 10.1016/j.bja.2022.10.018.
- 124. Favata A, Gallart-Agut R, van Noort L, et al. IMU-based kinematic analysis to enhance upper limb motor function assessment in neuromuscular diseases[J/OL]. J Neuroeng Rehabil, 2025, 22(1): 63. DOI: 10.1186/s12984-025-01602-2.
- 125. Shu'aibu Hikima M, Idris N, Suwaid MA, et al. Variation between imaging and non-imaging transcranial Doppler systems versus a phantom Doppler generated velocity[J]. Am J Hematol, 2025, 100(4): 744-746.
- 126. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性卒中診治指南(2023版)[J]. 中華神經科雜志, 2024, 57(6): 523-559.Chinese Society of Neurology, Cerebrovascular Disease Group of Chinese Society of Neurology. Chinese guidelines for diagnosis and treatment of acute ischemic stroke (2023 edition)[J]. Chin J Neurol, 2024, 57(6): 523-559.
- 127. Yuen MM, Prabhat AM, Mazurek MH, et al. Portable, low-field magnetic resonance imaging enables highly accessible and dynamic bedside evaluation of ischemic stroke[J/OL]. Sci Adv, 2022, 8(16): eabm3952. DOI: 10.1126/sciadv.abm3952.
- 128. Kim JH, Noh Y, Lee H, et al. Toward automated detection of microbleeds with anatomical scale localization using deep learning[J/OL]. Med Image Anal, 2025, 101: 103415. DOI: 10.1016/j.media.2024.103415.
- 129. Xia Y, Ravikumar N, Lassila T, et al. Virtual high-resolution MR angiography from non-angiographic multi-contrast MRIs: synthetic vascular model populations for in-silico trials[J/OL]. Med Image Anal, 2023, 87: 102814. DOI: 10.1016/j.media.2023.102814.
- 130. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國急性缺血性腦卒中診治指南2018[J]. 中華神經科雜志, 2018, 51(9): 666-682.Chinese Society of Neurology, Cerebrovascular Disease Group of Chinese Society of Neurology. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018[J]. Chin J Neurol, 2018, 51(9): 666-682.
- 131. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association[J/OL]. Stroke, 2019, 50(12): e344-e418. DOI: 10.1161/STR.0000000000000211.
- 132. Mendelson SJ, Prabhakaran S. Diagnosis and management of transient ischemic attack and acute ischemic stroke: a review[J]. JAMA, 2021, 325(11): 1088-1098.
- 133. Kürten S, Munoz C, Beseoglu K, et al. Decompressive hemicraniectomy for malignant middle cerebral artery infarction including patients with additional involvement of the anterior and/or posterior cerebral artery territory-outcome analysis and definition of prognostic factors[J]. Acta Neurochir (Wien), 2018, 160(1): 83-89.
- 134. Pallesen LP, Barlinn K, Puetz V. Role of decompressive craniectomy in ischemic stroke[J/OL]. Front Neurol, 2019, 9: 1119. DOI: 10.3389/fneur.2018.01119.
- 135. Chen HS, Cui Y, Li XQ, et al. Effect of remote ischemic conditioning vs usual care on neurologic function in patients with acute moderate ischemic stroke: the RICAMIS randomized clinical trial[J]. JAMA, 2022, 328(7): 627-636.

