Schreuder A H C M, Franke C L, Koehler P J
Atrium Medisch Centrum (Parkstad), afd. Neurologie, Postbus 4446, 6401 CX Heerlen.
Ned Tijdschr Geneeskd. 2008 Nov 29;152(48):2596-9.
Carotid endarterectomy (CEA) reduces the risk of stroke in both symptomatic and asymptomatic patients with a high-grade stenosis of the internal carotid artery. Surgery, however, is less beneficial for women than for men. Besides gender, other factors, like degree ofstenosis and plaque morphology, influence the risk of stroke and the beneficial effect of CEA. A recent study shows that women, asymptomatic women in particular, have more stable atherosclerotic carotid plaques than men. Increasing knowledge regarding local plaque characteristics should be carried through to clinical practice. Further studies, especially prospective studies, are needed to identify subgroups of patients that will benefit most from CEA. Low surgical morbidity and mortality remain a prerequisite to perform CEA in symptomatic carotid stenosis and even more so in asymptomatic carotid stenosis.
颈动脉内膜切除术（CEA）可降低有症状和无症状的颈内动脉高度狭窄患者的中风风险。然而，手术对女性的益处不如男性。除了性别，其他因素，如狭窄程度和斑块形态，也会影响中风风险和CEA的有益效果。最近一项研究表明，女性，尤其是无症状女性，比男性有更稳定的颈动脉粥样硬化斑块。应将有关局部斑块特征的更多知识应用于临床实践。需要进一步研究，尤其是前瞻性研究，以确定最能从CEA中获益的患者亚组。低手术发病率和死亡率仍然是对有症状颈动脉狭窄患者进行CEA的前提条件，对无症状颈动脉狭窄患者更是如此。
