Bonati Leo
Department of Neurology, Stroke Center, University Hospital Basel, Petersgraben 4, Basel CH-4031, Switzerland.
Neurol Clin. 2015 May;33(2):459-74. doi: 10.1016/j.ncl.2015.01.001. Epub 2015 Feb 28.
Carotid artery stenting is a less invasive alternative to endarterectomy to treat symptomatic carotid stenosis. Clinical trials showed a higher periprocedural risk of nondisabling stroke with stenting, and a higher periprocedural risk of myocardial infarction, cranial nerve palsy, and access site hematoma with endarterectomy. The excess in procedure-related strokes with stenting is mainly seen in patients aged 70 and over. After the procedural period, stenting and endarterectomy are equally effective in preventing stroke and recurrent carotid stenosis in the medium to long term. The choice of stenting versus endarterectomy should take into account risks of both procedures in individual patients.
颈动脉支架置入术是一种侵入性较小的治疗有症状颈动脉狭窄的方法，可替代动脉内膜切除术。临床试验表明，支架置入术围手术期发生非致残性卒中的风险较高，而动脉内膜切除术围手术期发生心肌梗死、颅神经麻痹和穿刺部位血肿的风险较高。支架置入术相关卒中的增加主要见于70岁及以上的患者。在围手术期之后，支架置入术和动脉内膜切除术在中长期预防卒中和复发性颈动脉狭窄方面同样有效。选择支架置入术还是动脉内膜切除术应考虑个体患者两种手术的风险。
