Kaźmierski Maciej K
III Kliniki Kardiologii Slaskiej Akademii Medycznej w Katowicach.
Wiad Lek. 2003;56(5-6):260-5.
Atherosclerotic stenosis of carotid arteries is present in approximately 9% of patients above 60 years of age. The stenosis may be silent or may cause cerebral ischaemia--transient or permanent, including severe stroke leading to death. It is estimated that 20-25% of all strokes is caused by carotid artery stenosis in their extracranial course. Ultrasound technique with Doppler recording is an efficient method of carotid arteries stenoses assessment. Asymptomatic carotid artery stenosis treated with acetylsalicylic acid 325 mg/day bears 6-11% risk of stroke in 5 years follow-up. The risk of cerebral ischaemia is significantly higher in persons with symptomatic stenoses. The risk of TIA or stroke recurrence reaches 30-45%. The treatment of carotid arteries stenoses comprises risk factors management and revascularisation procedures. Surgical treatment decreases the risk of stroke by 17%. Surgical endarterectomy perceived as the gold standard of interventional treatment may be efficiently replaced with percutaneous angioplasty with concomitant intravascular stent implantation.
在60岁以上的患者中,约9%存在颈动脉粥样硬化狭窄。这种狭窄可能没有症状,也可能导致脑缺血——短暂性或永久性的,包括导致死亡的严重中风。据估计,所有中风中有20% - 25%是由颅外段颈动脉狭窄引起的。带有多普勒记录的超声技术是评估颈动脉狭窄的有效方法。每天服用325毫克乙酰水杨酸治疗无症状颈动脉狭窄,在5年随访中有6% - 11%的中风风险。有症状狭窄的患者发生脑缺血的风险明显更高。短暂性脑缺血发作(TIA)或中风复发的风险达到30% - 45%。颈动脉狭窄的治疗包括危险因素管理和血管重建手术。手术治疗可将中风风险降低17%。被视为介入治疗金标准的外科内膜切除术可有效地被经皮血管成形术并同时植入血管内支架所取代。