Biller J, Love B B
Department of Neurology, Northwestern University Medical School, Chicago.
Geriatrics. 1992 Dec;47(12):47-51.
Several ongoing studies are evaluating the optimal management of patients with cerebrovascular disease. The Carotid Artery Stenosis with Asymptomatic Narrowing: Operation Versus Aspirin (CASANOVA) study has shown that carotid endarterectomy is not recommended for asymptomatic patients with less than 90% carotid stenosis. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgical Trial (ECST) have demonstrated that endarterectomy should be considered for patients who had recent carotid artery territory ischemic symptoms associated with angiographically defined stenosis of greater than 70%. These and other trials are expected to provide further data regarding management of cerebrovascular disease, including treatment of those patients with moderate (30 to 69%) carotid stenosis. Until that time, treatment decisions must be made on a case-to-case basis.
多项正在进行的研究正在评估脑血管疾病患者的最佳管理方案。“无症状性颈动脉狭窄：手术与阿司匹林治疗比较研究（CASANOVA）”表明，对于颈动脉狭窄小于90%的无症状患者，不建议进行颈动脉内膜切除术。北美症状性颈动脉内膜切除术试验（NASCET）和欧洲颈动脉外科试验（ECST）已证明，对于近期有与血管造影显示的大于70%的狭窄相关的颈动脉供血区缺血症状的患者，应考虑进行内膜切除术。这些试验和其他试验有望提供有关脑血管疾病管理的更多数据，包括对中度（30%至69%）颈动脉狭窄患者的治疗。在此之前，治疗决策必须根据具体情况做出。
