Link J, Manke C, Rosin L, Borisch I, Töpel I, Horn M, Mann S, Jauch K W, Bogdahn U, Feuerbach S, Kasprzak P
Institut für Röntgendiagnostik, Universitätsklinikum Regensburg.
Radiologe. 2000 Sep;40(9):813-20. doi: 10.1007/s001170050828.
A prospective, randomized and controlled trial is conducted to compare carotid endarterectomy and carotid stenting in high grade symptomatic carotid artery stenoses.
According to the study design symptomatic patients with a angiographically high-grade (> or = 70%) internal carotid artery stenosis are included. Pre- and postinterventional diagnostics during the hospitalization period includes neurological assessment, duplex sonography of the cervical and cerebral arteries and magnetic resonance imaging of the brain. Follow-up examinations are scheduled after 1, 6 and 12 months and consist of a neurological assessment and duplex sonography. After 12 months selective angiography and magnetic resonance imaging of the brain will be performed additionally. During a period of 9 months up to now 23/137 patients treated for a carotid artery stenosis were included in the study, 11 patients underwent surgery and 12 patients carotid stenting.
Carotid stenting and endarterectomy was primarily successful without residual stenosis > 30% in each patient without the occurrence of stroke or death. In 18 follow-up examinations (neurological assessment including duplex sonography) of 13 patients (13 follow-up examinations after 30 days, 5 after 6 months) no relevant restenosis and no stroke occurred.
As of yet, carotid stenting was a safe procedure. Due to the small number of patients a definitive conclusion can not be drawn.
开展一项前瞻性、随机对照试验，比较颈动脉内膜切除术和颈动脉支架置入术治疗有症状的重度颈动脉狭窄的效果。
根据研究设计，纳入血管造影显示为重度（≥70%）颈内动脉狭窄的有症状患者。住院期间干预前后的诊断包括神经学评估、颈部和脑动脉的双功超声检查以及脑部磁共振成像。随访检查安排在1、6和12个月后，包括神经学评估和双功超声检查。12个月后还将额外进行选择性血管造影和脑部磁共振成像。截至目前，在9个月的时间里，137例接受颈动脉狭窄治疗的患者中有23例被纳入研究，11例接受了手术，12例接受了颈动脉支架置入术。
颈动脉支架置入术和内膜切除术初步成功，每位患者均无残余狭窄>30%，也未发生中风或死亡。在对13例患者进行的18次随访检查（包括双功超声检查的神经学评估）中（30天后进行了13次随访检查，6个月后进行了5次），未出现相关再狭窄和中风。
目前，颈动脉支架置入术是一种安全的手术。由于患者数量较少，无法得出明确结论。
