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动脉内膜切除术或颈动脉支架置入术:探索仍在继续 第二部分

Endarterectomy or carotid artery stenting: the quest continues part two.

作者信息

Kolkert Joe L, Meerwaldt Robbert, Geelkerken Robert H, Zeebregts Clark J

机构信息

Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands.

Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands.

出版信息

Am J Surg. 2015 Feb;209(2):403-12. doi: 10.1016/j.amjsurg.2014.06.012. Epub 2014 Jul 28.

Abstract

BACKGROUND

Although randomized trials on carotid artery stenting (CAS) could not establish its equivalence to carotid endarterectomy (CEA) in patients with symptomatic carotid disease, CAS is rapidly evolving. Data on long-term outcome after CAS from randomized trials have now become available and ongoing, prospectively held registries frequently publish their results in increasing numbers of patients. We have therefore reviewed the currently available literature and provide an update of our previous article on this topic.

DATA SOURCES

PubMed literature searches were performed to identify relevant studies regarding current status of CEA and stenting for symptomatic carotid stenosis.

CONCLUSIONS

The efficacy of CAS in patients with symptomatic carotid artery stenosis remains unclear because of varying results in randomized trials. Although multiple registries do report promising results after CAS, peri-interventional stroke/death rates still exceed those rates currently found after CEA. Therefore, CEA remains the "gold standard" in treating these patients.

摘要

背景

尽管关于颈动脉支架置入术(CAS)的随机试验未能证实其在有症状颈动脉疾病患者中与颈动脉内膜切除术(CEA)等效,但CAS正在迅速发展。来自随机试验的CAS长期结果数据现已可得,并且正在进行的前瞻性登记研究也经常公布越来越多患者的结果。因此,我们回顾了当前可得的文献,并更新了我们之前关于该主题的文章。

数据来源

通过PubMed文献检索来识别关于CEA现状以及有症状颈动脉狭窄支架置入术的相关研究。

结论

由于随机试验结果各异,CAS在有症状颈动脉狭窄患者中的疗效仍不明确。尽管多个登记研究确实报告了CAS术后的良好结果,但围手术期卒中/死亡率仍超过目前CEA术后的发生率。因此,CEA仍然是治疗这些患者的“金标准”。

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