Roubin Gary S, Iyer Sriram, Halkin Amir, Vitek Jiri, Brennan Christina
Lenox Hill Hospital, New York, NY 10021, USA.
Circulation. 2006 Apr 25;113(16):2021-30. doi: 10.1161/CIRCULATIONAHA.105.595512.
Carotid artery stenting, compared with carotid endarterectomy, is emerging as an effective and less invasive method of revascularization for extracranial carotid artery stenosis. Carotid stenting is established as the treatment of choice for certain high-risk patient subsets, and ongoing clinical trials are evaluating this method across a broader clinical spectrum, including asymptomatic patients. For carotid stenting to reach its full potential, an acceptable risk of periprocedural complications, particularly in low-risk patients, must be ensured (the "3% rule"). The present article provides an in-depth review of carotid stenting, with special emphasis on the process of risk stratification pertaining to clinical, anatomic, and procedural considerations necessary to optimize procedural safety and patient outcomes.
与颈动脉内膜切除术相比，颈动脉支架置入术正逐渐成为一种治疗颅外颈动脉狭窄的有效且侵入性较小的血管重建方法。颈动脉支架置入术已成为某些高危患者亚组的首选治疗方法，并且正在进行的临床试验正在更广泛的临床范围内评估这种方法，包括无症状患者。为了使颈动脉支架置入术充分发挥其潜力，必须确保围手术期并发症的可接受风险，特别是在低风险患者中（“3%规则”）。本文对颈动脉支架置入术进行了深入综述，特别强调了与优化手术安全性和患者预后所需的临床、解剖和手术考虑相关的风险分层过程。
