Department of Neurology-Cannaday 2E, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA,
Curr Treat Options Neurol. 2010 Nov;12(6):475-82. doi: 10.1007/s11940-010-0092-7.
Recent randomized clinical trial data support the safety and efficacy of carotid artery stenting and carotid endarterectomy for treatment of symptomatic and asymptomatic carotid occlusive disease. Endarterectomy is more effective in preventing stroke, but this may be countered by a higher risk of perioperative myocardial infarction. Age is an important determinant in selecting patients for either carotid endarterectomy or stenting. Patients older than 70 years achieve better outcomes with endarterectomy, and younger patients achieve better outcomes with stenting. Comparative clinical and anatomic durability of endarterectomy and stenting will require additional follow-up from recently completed trials. The efficacy of carotid revascularization compared with modern medical therapy in asymptomatic patients remains an important and unanswered clinical question.
最近的随机临床试验数据支持颈动脉支架置入术和颈动脉内膜切除术治疗有症状和无症状颈动脉闭塞性疾病的安全性和有效性。内膜切除术在预防中风方面更有效，但这可能会被围手术期心肌梗死的风险更高所抵消。年龄是选择颈动脉内膜切除术或支架置入术患者的一个重要决定因素。70 岁以上的患者接受内膜切除术的效果更好，而年轻患者接受支架置入术的效果更好。内膜切除术和支架置入术的临床和解剖耐久性比较需要从最近完成的试验中进行更多的随访。在无症状患者中，颈动脉血运重建与现代药物治疗的疗效比较仍然是一个重要且尚未解决的临床问题。
