Schofer J, Bijuklic K
Medizinisches Versorgungszentrum Prof. Mathey, Prof. Schofer, Universitäres Herz- und Gefäßzentrum Hamburg, Wördemannsweg 25-27, 22527, Hamburg, Deutschland,
Herz. 2013 Nov;38(7):706-13. doi: 10.1007/s00059-013-3962-4.
Over the past 25 years carotid artery stenting (CAS) has emerged as an alternative to carotid endarterectomy (CEA). Most of all younger patients and symptomatic patients with contralateral carotid artery occlusion particularly benefit from CAS. To achieve an optimal result with CAS, patient selection and even more important, knowledge and experience of the interventionist is crucial. The periprocedural complication rate of CAS in large experienced centers is lower (2-3%) than those in randomized trials. Several different devices are now available which allow the procedure to be tailored according to patient anatomy and lesion complexity. Complications like hyperperfusion syndrome and intracerebral bleeding, rupture of side branches of the external or internal carotid artery as well as problems caused by slow flow can be widely avoided by adequate experience.
在过去25年里，颈动脉支架置入术（CAS）已成为颈动脉内膜切除术（CEA）的替代方法。尤其是大多数年轻患者以及对侧颈动脉闭塞的有症状患者，特别受益于CAS。为了通过CAS获得最佳效果，患者的选择以及更重要的是，介入医生的知识和经验至关重要。在大型经验丰富的中心，CAS的围手术期并发症发生率（2%-3%）低于随机试验中的发生率。现在有几种不同的设备可供使用，这使得该手术能够根据患者的解剖结构和病变复杂性进行调整。通过足够的经验，可以广泛避免诸如高灌注综合征和脑出血、颈外动脉或颈内动脉分支破裂以及血流缓慢引起的问题等并发症。
