Department of Neurology, University of North Carolina at Chapel Hill, Box 7025, Room 2131, 170 Manning Drive, Chapel Hill, NC, 27599, USA,
Curr Treat Options Neurol. 2011 Dec;13(6):608-15. doi: 10.1007/s11940-011-0145-6.
• Patients with acute ischemic stroke due to atherosclerotic carotid artery occlusion (ACAO) should receive intravenous tissue plasminogen activator (alteplase) if they meet eligibility criteria of the National Institute of Neurological Disorders and Stroke (NINDS) or the European Cooperative Acute Stroke Study III (ECASS III). • Patients with acute stroke due to ACAO who are not eligible for intravenous tissue plasminogen activator should receive aspirin. Heparin or heparin-like drugs do not improve outcome and should not be used. • Therapy for prevention of recurrent stroke in patients with ACAO should consist of lifestyle modifications, risk factor intervention, and antiplatelet drugs. Warfarin is not indicated. • Extracranial-intracranial bypass surgery provides no benefit over medical therapy in preventing recurrent stroke in a general population of patients with ACAO or in any subgroups selected by clinical, arteriographic, or hemodynamic criteria. • Other surgical or endovascular procedures have no proven value in treating or preventing stroke due to ACAO. • Asymptomatic carotid occlusion has a benign prognosis and requires no specific treatment other than lifestyle modification and risk factor intervention.
• 因动脉粥样硬化性颈动脉闭塞（ACAO）导致急性缺血性脑卒中的患者，如果符合美国国立神经病学与卒中研究所（NINDS）或欧洲合作急性脑卒中研究 III 期（ECASS III）的入选标准，应接受静脉注射组织型纤溶酶原激活剂（阿替普酶）治疗。• 不符合静脉注射组织型纤溶酶原激活剂治疗标准的 ACAO 所致急性脑卒中患者，应接受阿司匹林治疗。肝素或类肝素药物不能改善预后，不应使用。• ACAO 患者预防卒中复发的治疗方法包括生活方式调整、危险因素干预和抗血小板药物治疗。华法林不适用。• 颅外-颅内旁路手术并不能降低 ACAO 患者或任何按临床、血管造影或血流动力学标准选择的亚组患者的卒中复发风险，不能优于药物治疗。• 其他手术或血管内操作对治疗或预防 ACAO 所致脑卒中并无确切价值。• 无症状性颈动脉闭塞预后良好，除了生活方式调整和危险因素干预之外，无需特殊治疗。
