Donas Konstantinos P, Mayer Dieter, Guber Ivo, Baumgartner Ralf, Genoni Michele, Lachat Mario
Clinic for Cardiovascular Surgery, Zurich University Hospital, Raemisstrasse 100, CH-8091 Zurich, Switzerland.
J Vasc Interv Radiol. 2008 Dec;19(12):1693-8. doi: 10.1016/j.jvir.2008.08.025. Epub 2008 Oct 8.
To provide evidence for the endovascular repair of patients with extracranial carotid artery dissection.
A comprehensive literature review was performed whereby all studies that reported on the results of endoluminal repair of extracranial carotid artery dissection and provided information about primary technical and clinical success were identified. The Pubmed, Embase, and Medline databases were searched between January 1997 and February 2008 by two independent observers by using combinations of search terms "endovascular repair," "extracranial carotid artery," and "carotid dissection."
After studies were selected according to the given criteria, 13 studies were included in our statistical analysis. The number of reported patients was 62, with a total of 63 extracranial carotid artery dissections. The mean patient age was 43.3 years. The mean follow-up period was 15.7 months +/- 8.7. Various causes were responsible for the disease, including a blunt neck injury in 28 patients (45%), spontaneous dissection in 21 (37%), and iatrogenic trauma during invasive radiologic procedure in 17.7% patients. The technical success rate was 100% (63 of 63 procedures). The primary and 1-year patency rate of the stents and/or stent-grafts was 100%. The overall major adverse cardiovascular events rate was 11% (seven strokes). The total follow-up mortality rate was 0%.
The current status of the reported cases in the literature regarding the treatment of carotid artery dissection by means of stent placement shows excellent early and 1-year patency rates and a low major adverse cardiovascular event rate. However, further evaluation is necessary to draw robust conclusions.
为颅外颈动脉夹层患者的血管内修复提供依据。
进行全面的文献综述，确定所有报道颅外颈动脉夹层腔内修复结果并提供主要技术和临床成功信息的研究。两名独立观察者于1997年1月至2008年2月期间，通过使用“血管内修复”、“颅外颈动脉”和“颈动脉夹层”等搜索词组合，对PubMed、Embase和Medline数据库进行检索。
根据既定标准选择研究后，13项研究纳入我们的统计分析。报道的患者数量为62例，共63处颅外颈动脉夹层。患者平均年龄为43.3岁。平均随访期为15.7个月±8.7个月。该疾病由多种原因引起，包括28例患者（45%）颈部钝性损伤、21例（37%）自发性夹层以及17.7%患者在侵入性放射学检查过程中的医源性创伤。技术成功率为100%（63例手术中的63例）。支架和/或覆膜支架的初始和1年通畅率为100%。总体主要不良心血管事件发生率为11%（7例中风）。总随访死亡率为0%。
文献中报道的关于通过支架置入治疗颈动脉夹层的病例现状显示，早期和1年通畅率极佳，主要不良心血管事件发生率较低。然而，需要进一步评估以得出可靠结论。
