Washington Hospital Center, Georgetown University School of Medicine, Washington, DC 20010, USA.
J Vasc Surg. 2011 Sep;54(3):832-6. doi: 10.1016/j.jvs.2011.07.004.
In 2008, the Society for Vascular Surgery published guidelines for the treatment of carotid bifurcation stenosis. Since that time, a number of prospective randomized trials have been completed and have shed additional light on the best treatment of extracranial carotid disease. This has prompted the Society for Vascular Surgery to form a committee to update and expand guidelines in this area. The review was done using the GRADE methodology.[corrected] The perioperative risk of stroke and death in asymptomatic patients must be below 3% to ensure benefit for the patient. Carotid artery stenting (CAS) should be reserved for symptomatic patients with stenosis 50% to 99% at high risk for CEA for anatomic or medical reasons. CAS is not recommended for asymptomatic patients at this time. Asymptomatic patients at high risk for intervention or with <3 years life expectancy should be considered for medical management as first line therapy. In this Executive Summary, we only outline the specifics of the recommendations made in the six areas evaluated. The full text of these guidelines can be found on the on-line version of the Journal of Vascular Surgery at http://journals.elsevierhealth.com/periodicals/ymva.
2008 年，血管外科学会发布了治疗颈动脉分叉狭窄的指南。自那时以来，已经完成了许多前瞻性随机试验，进一步阐明了治疗颅外颈动脉疾病的最佳方法。这促使血管外科学会成立一个委员会来更新和扩展该领域的指南。审查使用 GRADE 方法进行。[纠正]无症状患者围手术期中风和死亡的风险必须低于 3%，以确保对患者有益。颈动脉支架置入术（CAS）应保留给有症状的患者，这些患者因解剖或医学原因，狭窄 50%至 99%，CEA 风险高。目前不建议对无症状患者进行 CAS。对于有介入治疗高风险或预期寿命<3 年的无症状患者，应考虑作为一线治疗的药物治疗。在本执行摘要中，我们仅概述了在评估的六个领域中提出的建议的具体内容。这些指南的全文可在血管外科学会杂志的在线版本上找到，网址为 http://journals.elsevierhealth.com/periodicals/ymva。
