经颈动脉血运重建术的作用是什么？
What Is the Role of Transcarotid Artery Revascularization?
机构信息
Department of Surgery, Division of Vascular and Endovascular Surgery, UC San Diego, San Diego, CA, USA; Center for Learning and Excellence in Vascular & Endovascular Research (CLEVER), UC San Diego, San Diego, CA, USA; Altman Center for Clinical and Translational Research, 9452 Medical Center Drive - LL2W 502A, La Jolla, CA 92037, USA.
Department of Surgery, Division of Vascular and Endovascular Surgery, UC San Diego, San Diego, CA, USA; Center for Learning and Excellence in Vascular & Endovascular Research (CLEVER), UC San Diego, San Diego, CA, USA; Altman Center for Clinical and Translational Research, 9452 Medical Center Drive - LL2W 502A, La Jolla, CA 92037, USA.
出版信息
Adv Surg. 2023 Sep;57(1):115-140. doi: 10.1016/j.yasu.2023.04.010. Epub 2023 May 26.
Carotid endarterectomy (CEA) is the gold-standard method of carotid revascularization in symptomatic patients with ≥50% and in asymptomatic patients with ≥70% stenosis. Transfemoral carotid artery stenting (TFCAS) has been associated with higher perioperative stroke rates compared to CEA in several studies. On the other hand, transcarotid artery revascularization (TCAR) has outperformed TFCAS in patients who are considered high risk for surgery. There is increasing data that supports TCAR as a safe and efficient technique with outcomes similar to those of CEA, but additional level-one studies are necessary to evaluate the long-term outcomes of TCAR in high- and standard-risk patients.
颈动脉内膜切除术（CEA）是症状性患者≥50%和无症状患者≥70%狭窄的颈动脉血运重建的金标准方法。与 CEA 相比，几项研究表明经股动脉颈动脉支架置入术（TFCAS）与更高的围手术期卒中率相关。另一方面，在被认为手术风险较高的患者中，经颈动脉血运重建术（TCAR）优于 TFCAS。越来越多的数据支持 TCA 作为一种安全有效的技术，其结果与 CEA 相似，但需要进一步的一级研究来评估 TCA 在高风险和标准风险患者中的长期结果。
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