Ricotta Joseph J, Malgor Rafael D
Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, MN 55905,USA.
Perspect Vasc Surg Endovasc Ther. 2008 Sep;20(3):299-308. doi: 10.1177/1531003508324614. Epub 2008 Sep 25.
In the last decade, carotid artery angioplasty and stenting (CAS) has gained popularity as an alternative to carotid endarterectomy (CEA) for the treatment of carotid stenosis, particularly in patients who are at high operative risk. CAS offers the advantage of being a less invasive procedure, potentially minimizing the risks of wound complications and cranial nerve injury, which may translate into shorter length of hospitalization and less resource utilization. Since the advent of CAS, several randomized controlled trials and carotid stent registry trials have been conducted comparing the outcomes of CEA with those of CAS for the treatment of carotid stenosis in both symptomatic and asymptomatic patients. This review will summarize the results of randomized controlled trials (CAVATAS, WALLSTENT, SAPPHIRE, EVA-3S, SPACE, and CaRESS) as well as pivotal carotid registry studies (ARCHeR, BEACH, CAPTURE, CASES-PMS, CREATE, and CABernET) intended to evaluate the safety and efficacy of CEA and CAS in treatment of carotid stenosis. In addition, it will provide a preview of the current ongoing and future trials examining the safety, applicability, and indications of CAS and CEA (CREST, CAVATAS-2, ACT 1, and TACIT).
在过去十年中，颈动脉血管成形术和支架置入术（CAS）作为颈动脉内膜切除术（CEA）治疗颈动脉狭窄的替代方法已越来越受欢迎，尤其是在手术风险高的患者中。CAS具有侵入性较小的优点，有可能将伤口并发症和颅神经损伤的风险降至最低，这可能意味着住院时间更短和资源利用更少。自CAS出现以来，已经进行了几项随机对照试验和颈动脉支架注册试验，比较了CEA和CAS治疗有症状和无症状患者颈动脉狭窄的结果。本综述将总结随机对照试验（CAVATAS、WALLSTENT、SAPPHIRE、EVA - 3S、SPACE和CaRESS）以及关键的颈动脉注册研究（ARCHeR、BEACH、CAPTURE、CASES - PMS、CREATE和CABernET）的结果，这些研究旨在评估CEA和CAS治疗颈动脉狭窄的安全性和有效性。此外，它还将预览当前正在进行的以及未来研究CAS和CEA的安全性、适用性和适应症的试验（CREST、CAVATAS - 2、ACT 1和TACIT）。
