Sheffield Vascular Institute, Northern General Hospital, Herries Road, Sheffield, S5 7AU, UK,
Cardiovasc Intervent Radiol. 2013 Oct;36(5):1221-31. doi: 10.1007/s00270-013-0573-7. Epub 2013 Mar 8.
Carotid artery stenting (CAS) has evolved to treat carotid artery disease with the intention of prevent stroke. The British Society of Interventional Radiologists developed a voluntary registry to monitor the practice of this novel procedure. We present the data from the United Kingdom (UK) CAS registry for short and long-term outcomes for symptomatic and asymptomatic carotid disease.
The UK CAS registry collected data from 1998 to 2010 from 31 hospitals across the UK for 1,154 patients. All interventions were enrolled in the registry for both asymptomatic and symptomatic patients. Initial entry forms were completed for each patient entered with data including indications, demographic data, CAS data (including stents and protection device details) and 30-day outcomes. Complications were documented. Follow-up data were collected at yearly intervals.
Nine hundred fifty-three (83 %) symptomatic and 201 (17 %) asymptomatic patients were enrolled into the registry. The 30-day all stroke and death rates for symptomatic patients were 5.5 and 2.2 % for those with asymptomatic disease. The 30-day mortality rate was 1.7 % for symptomatic and 0.6 % for asymptomatic patients. For symptomatic patients undergoing CAS, the 7-year all-cause mortality rate was 22.2 % and for asymptomatic patients 18.1 %. The 7-year all-cause mortality and disabling stroke rates were 25.3 and 19.4 %, respectively.
These data indicate that outside of the tight constraints of a randomised trial, CAS provides effective prophylaxis against stroke and death.
颈动脉支架置入术(CAS)已发展成为治疗颈动脉疾病的一种手段,旨在预防中风。英国介入放射学家学会建立了一个自愿注册系统,以监测该新型手术的实施情况。我们报告了英国颈动脉支架置入术注册系统(UK CAS registry)针对症状性和无症状性颈动脉疾病的短期和长期结局数据。
UK CAS registry 自 1998 年至 2010 年,从英国 31 家医院共纳入了 1154 例患者的数据。所有介入治疗均在该注册系统中登记,包括无症状和有症状患者。每个患者的初始登记表中都包含适应证、人口统计学数据、CAS 数据(包括支架和保护装置的详细信息)和 30 天结局。记录并发症情况。每年收集随访数据。
953 例(83%)症状性和 201 例(17%)无症状患者被纳入该注册系统。症状性患者的 30 天全因卒中和死亡率分别为 5.5%和 2.2%,无症状性疾病患者的 30 天死亡率为 1.7%和 0.6%。对于接受 CAS 的症状性患者,7 年全因死亡率为 22.2%,无症状患者为 18.1%。7 年全因死亡率和致残性卒中年发生率分别为 25.3%和 19.4%。
这些数据表明,在随机试验的严格限制之外,CAS 可有效预防中风和死亡。