Velz Julia, Esposito Giuseppe, Wegener Susanne, Kulcsar Zsolt, Luft Andreas, Regli Luca
Klinik für Neurochirurgie, Klinisches Neurozentrum, Universitätsspital Zürich.
Universität Zürich.
Praxis (Bern 1994). 2020 Jul;109(9):705-723. doi: 10.1024/1661-8157/a003475.
Diagnostic and Therapeutic Management of Carotid Artery Disease A quarter of all ischemic strokes is caused by atherosclerotic obliterations of the extra- and intracranial brain-supplying vessels. The prevalence of atherosclerotic extracranial carotid stenosis rises up to 6-15 % from the age of 65. The risk of stroke in symptomatic carotid stenosis, i.e. after stroke or transient ischemic attack (TIA), is very high at 25 % within 14 days. Conservative therapy is the cornerstone of treatment by controlling the risk factors, treatment with platelet aggregation inhibitors and antihypertensive and lipid-lowering medication. Carotid endarterectomy (CEA) is the first line treatment for symptomatic patients with a >50 % and asymptomatic patients with a >60 % carotid stenosis. In order to ensure the best possible treatment of patients with asymptomatic and symptomatic carotid stenosis, interdisciplinary cooperation in diagnostics, therapy and aftercare in a neuromedical centre of maximum care is necessary.
颈动脉疾病的诊断与治疗管理 所有缺血性中风中有四分之一是由颅外和颅内脑供血血管的动脉粥样硬化闭塞引起的。从65岁起，动脉粥样硬化性颅外颈动脉狭窄的患病率上升至6%-15%。有症状的颈动脉狭窄患者，即中风或短暂性脑缺血发作（TIA）后的中风风险在14天内非常高，为25%。保守治疗是通过控制危险因素、使用血小板聚集抑制剂以及抗高血压和降脂药物进行治疗的基石。颈动脉内膜切除术（CEA）是有症状且颈动脉狭窄>50%的患者以及无症状且颈动脉狭窄>60%的患者的一线治疗方法。为了确保对无症状和有症状的颈动脉狭窄患者进行尽可能最佳的治疗，在最高护理级别的神经医学中心进行诊断、治疗和术后护理的跨学科合作是必要的。
