Halbritter K, Weiss N
UniversitätsGefässCentrum und Medizinische Klinik III, Bereich Angiologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Internist (Berl). 2013 Jun;54(6):715-25. doi: 10.1007/s00108-013-3277-9.
Stenosis of the extracranial carotid artery is a treatable cause of ischemic stroke and can reliably be detected and graded by vascular ultrasound. The differentiation between symptomatic and asymptomatic stenosis, the perioperative risk and the estimated life expectancy of the patient guide the therapy. Therapy is based on an optimal treatment of cardiovascular risk factors and antiplatelet drugs. Revascularization using surgical carotid endarterectomy is efficient for the prevention of stroke in patients with a high grade symptomatic stenosis. Endovascular therapy using stent-protected angioplasty of the carotid artery is an alternative in patients with a higher surgical risk with low complication rates when performed in experienced centres. Patients with asymptomatic carotid artery stenosis are primarily treated conservatively and revascularization is indicated in patients with a low surgical and global cardiovascular risk.
颅外颈动脉狭窄是缺血性卒中的一个可治疗病因，可通过血管超声可靠地检测和分级。有症状和无症状狭窄的鉴别、围手术期风险以及患者的预期寿命指导治疗。治疗基于对心血管危险因素的最佳治疗和抗血小板药物。对于有高度症状性狭窄的患者，采用外科颈动脉内膜切除术进行血运重建对预防卒中有效。在经验丰富的中心进行时，使用颈动脉支架保护血管成形术的血管内治疗是手术风险较高、并发症发生率低的患者的一种替代方法。无症状颈动脉狭窄患者主要采用保守治疗，对于手术和整体心血管风险较低的患者则需进行血运重建。
