Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida; Miami Veteran Affairs Hospital, Miami, Florida.
Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida.
J Am Coll Cardiol. 2015 Mar 24;65(11):1134-43. doi: 10.1016/j.jacc.2014.12.045.
Carotid atherosclerosis accounts for approximately 10% of ischemic stroke cases. Multifaceted medical therapy reduces the risk of stroke in patients with carotid stenosis. Revascularization with endarterectomy or stenting can benefit select patients. In recent years, new information has been obtained regarding optimal selection of revascularization candidates. In addition, new concepts have been formulated regarding the relationship between carotid stenosis and vascular cognitive impairment. Finally, the declining rate of stroke with improved medical therapy has led to the launch of new clinical trials to determine the contemporary risk/benefit ratio of revascularization relative to aggressive medical therapy.
颈动脉粥样硬化约占缺血性脑卒中病例的 10%。多方位的医学治疗可降低颈动脉狭窄患者发生脑卒中的风险。血管内内膜切除术或支架置入术等血运重建治疗可使部分患者获益。近年来，有关血运重建候选者的最佳选择方面有了新的信息。此外，关于颈动脉狭窄与血管性认知障碍之间的关系也有了新的认识。最后，随着医学治疗的进步，脑卒中的发病率呈下降趋势，这促使开展了新的临床试验，以确定相对于强化医学治疗，血运重建的当代风险/获益比。
